Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Traci Leigh Blake, DNP, ACNPC-AG, CRNFA

Individual provider Registered Nurse First Assistant · NPI 1649543042

Traci Leigh Blake, DNP, ACNPC-AG, CRNFA is a Nurse Practitioner in Rockford, Illinois. Qualified in 2024, 2 years ago. Practices with Rockford Health Physicians, a 521-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2012
Specialties on file
2
What do these letters mean?
DNP — Doctor of Nursing Practice
The highest clinical degree in nursing.

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Practice location Address checks out

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone: (815) 971-7000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1401 E State St, Rockford, IL 61104-2315 — (779) 696-7150
  • 1000 Mineral Point Ave, Janesville, WI 53548-2982 — (608) 756-6868

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 209032163 (IL)
Registered Nurse First Assistant Taxonomy 163WR0006X · Licence 041336983 (IL)

Record details

NPI number1649543042
Entity typeIndividual (Type 1)
GenderFemale
Credentials DNP , ACNPC-AG , CRNFA
Sole proprietorNo
NPI enumeratedFebruary 15, 2012
Last updated in NPPESMay 1, 2025
Certification dateMay 1, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Rockford Health Physicians — 521 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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