Individual
NICHOLE MARIE BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
522 N MAIN ST, ELK CITY, OK 73644-4241
(580) 243-2200
(580) 303-4712
Mailing address
11000 HEFNER POINTE DR, OKLAHOMA CITY, OK 73120-5039
(405) 749-9655
(405) 749-1001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
211675
OK
Other
Enumeration date
02/03/2023
Last updated
01/27/2025
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