Provider Demographics
NPI:1053099226
Name:BLACKABY, ASHLEE NICOLE (DNP, APRN-CRNA)
Entity type:Individual
Prefix:MRS
First Name:ASHLEE
Middle Name:NICOLE
Last Name:BLACKABY
Suffix:
Gender:F
Credentials:DNP, APRN-CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13900 N 3983 DR
Mailing Address - Street 2:
Mailing Address - City:DEWEY
Mailing Address - State:OK
Mailing Address - Zip Code:74029-3906
Mailing Address - Country:US
Mailing Address - Phone:918-766-2759
Mailing Address - Fax:
Practice Address - Street 1:1120 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4090
Practice Address - Country:US
Practice Address - Phone:918-579-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK122282163WC0200X
OK215224207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine