Individual
MRS. CODY BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9901 N MAY AVE STE 110, OKLAHOMA CITY, OK 73120-2734
(405) 849-5624
Mailing address
538 HIWASSEE DR, DECATUR, TN 37322-6033
(405) 406-7977
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
272468
TN
Other
Enumeration date
11/28/2016
Last updated
12/03/2024
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