Provider Demographics
NPI:1487540126
Name:LUY, BLAKE WILLIAM
Entity type:Individual
Prefix:
First Name:BLAKE
Middle Name:WILLIAM
Last Name:LUY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:EARLY
Mailing Address - State:IA
Mailing Address - Zip Code:50535-0041
Mailing Address - Country:US
Mailing Address - Phone:712-299-2135
Mailing Address - Fax:
Practice Address - Street 1:2015 W 5TH ST
Practice Address - Street 2:
Practice Address - City:STORM LAKE
Practice Address - State:IA
Practice Address - Zip Code:50588-3000
Practice Address - Country:US
Practice Address - Phone:712-732-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA184884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily