Charles Blagovich Valid NPI

Individual provider · Family Nurse Practitioner · Tulsa, OK

NPI

1053763334

Type

Individual (Type 1)

Primary specialty

Family Nurse Practitioner (Nurse Practitioner)

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363LF0000X

License number

121198 (OK)

Sex

Male

Sole proprietor

Yes

Enumerated

2016-07-11

Last updated

2016-07-11