Individual
LISA ANN BLOXHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3200
Mailing address
3404 W KNOXVILLE ST, BROKEN ARROW, OK 74012-4657
(918) 645-9411
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
R0099475
OK
363LF0000X
Family Nurse Practitioner
Primary
99475
OK
Other
Enumeration date
04/03/2019
Last updated
07/17/2019
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