TISHA BLACKSTAR

LAWTON, OK
NPI1932794765
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: OK  60269)
Enumeration Date2021-03-03
Last Update Date2021-03-03
Business Address
TISHA BLACKSTAR LPN
1515 NE LAWRIE TATUM RD
LAWTON, OK 73507-3099
Phone number: 580-354-5000
Mailing Address
TISHA BLACKSTAR LPN
1515 NE LAWRIE TATUM RD
LAWTON, OK 73507-3099
Phone number: 580-354-5000