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

Opal Mullings Blake, NP-C

Individual provider Nurse Practitioner · NPI 1043629140

Opal Mullings Blake, NP-C is a Nurse Practitioner in Lawrenceville, Georgia. Qualified in 2014, 12 years ago. Practices with Gwinnett Pulmonary Group, a 17-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2014
Specialties on file
2
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

631 Professional Dr Ste 350
Lawrenceville, GA 30046-3370
Phone: (770) 995-0630
Fax: (770) 995-1555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN 199200 (GA)
Nurse Practitioner Taxonomy 363L00000X · Licence RN199200 (GA)

Record details

NPI number1043629140
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedAugust 4, 2014
Last updated in NPPESJanuary 4, 2016
Mailing address631 Professional Dr, Suite 350, Lawrenceville, GA 30046

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Gwinnett Pulmonary Group — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Lawrenceville