Individual
VICTORIA BROOKE BLAYLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6245
(479) 452-0275
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(479) 314-6245
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
215360
OK
363LF0000X
Family Nurse Practitioner
Primary
236977
AR
Other
Enumeration date
09/27/2023
Last updated
05/04/2026
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