Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Danielle Rebecca Blake

Individual provider Registered Nurse · NPI 1265900450

Danielle Rebecca Blake is a Nurse Practitioner in Fenton, Missouri. Qualified in 2017, 9 years ago. Practices with SSM Medical Group Inc, a 560-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
9
Licensed in
MO
In the registry since
2018
Specialties on file
2

Practice location Address checks out

1055 Bowles Ave Ste 200
Fenton, MO 63026-2308
Phone: (636) 496-3900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2018011508 (MO)
Registered Nurse Taxonomy 163W00000X · Licence 2013025839 (MO)

Record details

NPI number1265900450
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 6, 2018
Last updated in NPPESDecember 18, 2024
Certification dateDecember 18, 2024
Mailing addressPo Box 955534, Saint Louis, MO 63195-5534

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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