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

Mary L. Blake, ANP-C

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1164780177

Mary L. Blake, ANP-C is a Nurse Practitioner in Charlotte, North Carolina. Qualified in 2011, 15 years ago. Accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
15
Licensed in
NC
In the registry since
2012
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Practice location Address checks out

2936 Caldwell Ridge Pkwy
Charlotte, NC 28213-5888
Phone: (704) 578-8041
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 5005601 (NC)

Record details

NPI number1164780177
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP-C
Sole proprietorNo
NPI enumeratedApril 26, 2012
Last updated in NPPESAugust 28, 2025
Certification dateAugust 28, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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