Heather Janelle Blagg, CNP
Individual provider Active NPI Family Nurse Practitioner · Clayton, OK
NPI 1073296604 · NPPES record last updated Aug 10, 2023
Key facts
- NPI
- 1073296604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 214759 (OK)
- Practice address
- 1020 N Lawson Blvd
Clayton, OK 74536 - Phone
- (918) 917-9999
- Fax
- (918) 569-7343
- NPI assigned
- Aug 10, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250726000002 | TX | Practitioner - Nurse Practitioner | 3072960442 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 214759 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Choctaw Nation of Oklahoma | Current |
Accepting new patients | |
| Choctaw Nation of Oklahoma | Current |
Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients |
Locations
1585 W Liberty Rd
Atoka, OK 74525
Phone (580) 889-1981
1300 E Martin Luther King Dr
Broken Bow, OK 74728
Phone (580) 208-2204
410 N M St
Hugo, OK 74743
Phone (580) 326-7561
902 E Lincoln Rd
Idabel, OK 74745
Phone (580) 286-2600
1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026
109 Kerr Blvd
Poteau, OK 74953
Phone (918) 649-1100
2204 E Main St
Stigler, OK 74462
Phone (918) 967-9200
1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440
205 Dallas St
Talihina, OK 74571
Phone (918) 567-3636
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 214759 | OK | Yes |
Addresses
Primary practice location
1020 N Lawson Blvd
Clayton, OK 74536
Mailing address
PO Box 219
Clayton, OK 74536-0219
Phone (918) 917-9999
Other providers in Clayton, OK
- Kimberly Ann Baughman
- Best Life RX, LLC
- Best Life RX, LLC
- Paula Sue Brown
- Clayton Pharmacy
- Clayton Public School
- Curatio Hospice Inc
- Mitsi A Faubion
All providers in Clayton, OK · Family Nurse Practitioner in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.