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Individual

DONNA C. BLACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
4300 W MEMORIAL RD, ER DEPT, OKLAHOMA CITY, OK 73120-8304
(405) 752-3733
(405) 749-4561
Mailing address
4401 W MEMORIAL RD, SUITE 121, OKLAHOMA CITY, OK 73134-1785
(405) 751-4664
(405) 749-4561

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0042209
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100204550B
OK
05
100204550P
OK
Enumeration date
04/04/2006
Last updated
12/18/2009
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