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1932794765
TISHA BLACKSTAR
LAWTON, OK
NPI
1932794765
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: OK 60269)
Enumeration Date
2021-03-03
Last Update Date
2021-03-03
Business Address
TISHA BLACKSTAR LPN
1515 NE LAWRIE TATUM RD
LAWTON, OK 73507-3099
Phone number: 580-354-5000
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Mailing Address
TISHA BLACKSTAR LPN
1515 NE LAWRIE TATUM RD
LAWTON, OK 73507-3099
Phone number: 580-354-5000
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