Blake Alan Ardrey
Individual provider Active NPI Peer Specialist · Nowata, OK
NPI 1649948415 · NPPES record last updated Sep 5, 2021
Key facts
- NPI
- 1649948415
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 325 S Ash St
Nowata, OK 74048-4628 - Phone
- (918) 706-6529
- NPI assigned
- Sep 5, 2021
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Yes |
Addresses
Primary practice location
325 S Ash St
Nowata, OK 74048-4628
Mailing address
325 S Ash St
Nowata, OK 74048-4628
Other providers in Nowata, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.