Individual
ASHLEY MARIE BLALACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6101
(918) 779-7117
Mailing address
2090 S LYNN RIGGS BLVD APT 37, CLAREMORE, OK 74019-5545
(479) 280-8130
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
R105889
AR
Other
Enumeration date
03/07/2025
Last updated
03/07/2025
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