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General NPI Number Information
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NPI Number | 1740629526
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Entity Type | Individual
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Provider Name | MS. NICOLE LYNN BLEVINS
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Gender | Female
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 4200 PERIMETER CENTER DR STE 150
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2328
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Country | US
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Telephone | 405-230-1900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12147
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City | OKLAHOMA CITY
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State | OK
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Zip | 73157-2147
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Country | US
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Telephone | 405-230-1900
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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