Individual
BLAKE ROBERT RAWLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9600 BROADWAY EXT, OKLAHOMA CITY, OK 73114-7408
(405) 230-9000
Mailing address
5005 NW 164TH TER, EDMOND, OK 73013-9455
(405) 513-4212
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R0136141
OK
Other
Enumeration date
06/09/2025
Last updated
06/09/2025
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