Ashley Marie Blalack, RN

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

R105889 Issued in AR

Practice address

6333 E Skelly Dr
Tulsa, OK 74135-6101

Phone

(918) 779-7117

NPI assigned

Mar 7, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1487452116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 S LYNN RIGGS BLVD APT 37",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740195545",
            "telephone_number": "479-280-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 E SKELLY DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356101",
            "telephone_number": "918-779-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALACK",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "AR",
            "license": "R105889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.@sanford.html",
            "affiliation": "N",
            "address_1": "6333 E Skelly Dr",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741356101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "securerecords.@sanford.html",
            "affiliation": "Y",
            "affiliationName": "Grand Lake Mental Health Center, Inc.",
            "address_1": "6333 E Skelly Dr",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741356101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristen Nicole Blake
• Samantha Jo Blake
• Jesse Blaker
• Monica Blakley
• Sarah Blakley
• Kathryn Lee Blalock, LCSW
• Lindsay Blalock, MD
• Martha Blan, LCSW
• Ashley Blanchard Ware, APRN
• Daven Blanchard

• Addiction (Substance Use Disorder) Registered Nurse in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.