John B Blackhart, RN

Individual provider Active NPI Critical Care Medicine Registered Nurse · Oklahoma City, OK

NPI 1467280693 · NPPES record last updated Jul 22, 2024

Key facts

NPI
1467280693
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine Registered Nurse 163WC0200X
License
R0135144 (OK)
Practice address
4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone
(405) 752-3715
NPI assigned
Jul 22, 2024
Sex
Male
Sole proprietor
No

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
R0135144OKMDCritical Care Medicine Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X R0135144 OK Yes

Addresses

Primary practice location

4300 W Memorial Rd
Oklahoma City, OK 73120-8304

Mailing address

125 Meadow LN
Chandler, OK 74834-8786
Phone (405) 397-1664

Other providers in Oklahoma City, OK

All providers in Oklahoma City, OK · Critical Care Medicine Registered Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.