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NPI Code Detail

MEDICARE: CASEY BLEDSOE LPN

MEDICARE: CASEY BLEDSOE LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical NurseL0050668OK

General Provider Information

NPI Number : 1740516673
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY BLEDSOE LPN
Provider Business Mailing Address
First Line : 2345 SOUTHWEST BLVD
Second Line :
City : TULSA
State : OK
Zip : 74107-2705
Country : US
Telephone Number : 918-561-1130
Fax Number : 918-561-5706
Provider Business Practice Location Address
First Line : 2345 SOUTHWEST BLVD
Second Line :
City : TULSA
State : OK
Zip : 74107-2705
Country : US
Telephone Number : 918-561-1130
Fax Number : 918-561-5706
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2009
Last Update Date : 12/17/2025

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Directions to “ CASEY BLEDSOE LPN” Practice Location

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