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

Lara Blake

Individual provider Family Medicine Physician · NPI 1881472371

Lara Blake is a Nurse Practitioner in Tupelo, Mississippi. Qualified in 2023, 3 years ago. Practices with North Mississippi Medical Clinics Inc, a 122-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Mississippi.

Years since qualifying
3
Licensed in
MS
In the registry since
2023
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Practice location Address checks out

845 S Madison St
Tupelo, MS 38801-4905
Phone: (662) 377-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 906281 (MS)

Record details

NPI number1881472371
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 18, 2023
Last updated in NPPESSeptember 18, 2023
Certification dateSeptember 18, 2023
Mailing address2056 New Chapel Rd, Nettleton, MS 38858-8257

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice North Mississippi Medical Clinics Inc — 122 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Tupelo