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General NPI Number Information
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NPI Number | 1376406850
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Entity Type | Organization
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Legal Business Name | BLUEPRINT SIGNATURE SERVICES LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 112 W DELMAR ST.
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City | BROKEN ARROW
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State | OK
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Zip | 74012
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Country | US
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Telephone | 855-395-0763
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Fax | 918-895-0969
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Provider Business Mailing Address
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Address Line | 3171 S 129TH EAST AVE STE A-2082
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City | TULSA
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State | OK
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Zip | 74134-3205
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Country | US
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Telephone | 855-395-0763
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Fax | 918-895-0969
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Authorized Official
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Title or Position | OWNER
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Name | SHAKEIA LASHAE GILL
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Credential |
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Telephone | 918-841-2359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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