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Individual

BLANCA CHARLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
4502 E 41ST ST, TULSA, OK 74135-2536
(918) 660-3071
Mailing address
11479 S 264TH EAST AVE, COWETA, OK 74429-6750
(918) 407-4999

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
98202
OK
163WD0400X
Diabetes Educator Registered Nurse
21420039
OK
171M00000X
Case Manager/Care Coordinator
Primary
OK

Other

Enumeration date
02/06/2024
Last updated
02/06/2024
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