Healthcare Provider Details

I. General information

NPI: 1538086061
Provider Name (Legal Business Name): EMILY BLAIR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10505 E 91ST ST STE 205
TULSA OK
74133-5829
US

IV. Provider business mailing address

10505 E 91ST ST STE 205
TULSA OK
74133-5829
US

V. Phone/Fax

Practice location:
  • Phone: 918-307-5490
  • Fax:
Mailing address:
  • Phone: 918-307-5490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number205448
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number205448
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: