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

Stephanie Blake, ATC/LAT

Individual provider Athletic Trainer · NPI 1144710815

Stephanie Blake, ATC/LAT is an Athletic Trainer in Walnut Ridge, Arkansas. Practices as a sole proprietor. Licensed in Arkansas.

Licensed in
AR
In the registry since
2018

Practice location Address checks out

60 W Fulbright St
Walnut Ridge, AR 72476-9000
Phone: (870) 208-5631
Show map & directions

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

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT701 (AR)

Record details

NPI number1144710815
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC/LAT
Sole proprietorYes
NPI enumeratedMay 17, 2018
Last updated in NPPESMay 17, 2018

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