Angela Maria Blose, RN

Individual provider Active NPI Child & Adolescent Psychiatric/Mental Health Registered Nurse · Mustang, OK

NPI 1013756709 · NPPES record last updated May 22, 2024

Key facts

NPI
1013756709
Entity type
Individual (NPI type 1)
Primary specialty
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X
License
R0134588 (OK)
Practice address
932 W State Highway 152
Mustang, OK 73064-2301
Phone
(405) 577-5477
NPI assigned
May 22, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R0134588OKMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Bridges Behavioral Health LLC Current
since May 26, 2024
Accepting new patients

Locations

932 W State Highway 152
Mustang, OK 73064
Phone (405) 577-5477

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatric/Mental Health Registered Nurse 163WP0807X R0134588 OK Yes

Addresses

Primary practice location

932 W State Highway 152
Mustang, OK 73064-2301

Mailing address

932 W State Highway 152
Mustang, OK 73064-2301

Other providers in Mustang, OK

All providers in Mustang, OK · Child & Adolescent Psychiatric/Mental Health Registered Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.