Shannon Blake, PA
Shannon Blake, PA is a Physician Assistant in West Hartford, Connecticut. Qualified in 2006, 20 years ago. Practices with Lifesource of North Carolina, a 170-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Connecticut.
- Years since qualifying
- 20
- Licensed in
- CT
- In the registry since
- 2006
What do these letters mean?
- PA — Physician Assistant
- A licensed clinician who examines, diagnoses and treats under a physician's supervision.
Practice location Address checks out
631 Quaker Ln SWest Hartford, CT 06110-1026
Phone: (860) 233-5133
Fax: (860) 232-6527
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 001550 (CT) |
|---|
Record details
| NPI number | 1578509238 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PA |
| Sole proprietor | No |
| NPI enumerated | June 21, 2006 |
| Last updated in NPPES | July 28, 2011 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2006 (20 years in practice) |
| Group practice | Lifesource Of North Carolina — 170 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Telehealth | Offers telehealth services |
| Practice locations | 2 on file with Medicare |
Other providers in West Hartford
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Brandon Batory, PA-C
1030 Blvd, West Hartford, CT 06119-1801 · (860) 986-6440
-
Mary Ryan Calnen, PA-C
65 Memorial Rd Ste 508, West Hartford, CT 06107-4233 · (860) 696-2925
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Diana Laura Castellanos, PA
342 N Main St Ste 350, West Hartford, CT 06117-2530 · (860) 296-4022
-
Michelle L Cavo, PA
125 Lasalle Rd Ste 208, West Hartford, CT 06107-2322 · (860) 906-1289
-
Erica Falger
65 Memorial Rd Ste 435, West Hartford, CT 06107-4205 · (860) 696-2840