BRANDI BLOSSOM (NPI# 1649784042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649784042 |
| Entity Type | Individual |
| Full Name | BRANDI BLOSSOM |
| Practice Address |
711 S Muskogee Ave Tahlequah OK 74464-4717 |
| Practice Telephone | 9182070078 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | 0054037 | OK | Nursing Service Providers |
| Street Address |
711 S MUSKOGEE AVE |
| City | TAHLEQUAH |
| State | OK |
| Zip Code | 74464-4717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043331499 | Creoks Mental Health Services | Community/Behavioral Health | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2007-04-03 |
| 1902403702 | Millissa Kae Robinson | Peer Specialist | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2020-10-05 |
| 1154947919 | Jennifer Ann Ruppel | Case Manager/Care Coordinator | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2020-06-17 |
| 1982238457 | Dawn Johnson | Counselor | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2020-02-24 |
| 1043850829 | Corey A Thornton | Counselor | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2020-01-09 |
| 1336785211 | Cortnie Cox | Case Manager/Care Coordinator | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2019-11-26 |
| 1851940324 | Christian Denell Riley | Behavioral Analyst | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2019-09-08 |
| 1134776008 | Martha J Smith | Registered Nurse | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2019-08-24 |
| 1700349883 | Heather Marie Askew | Peer Specialist | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2019-04-07 |
| 1124589395 | Ashlee Kay Morton | Case Manager/Care Coordinator | 711 S Muskogee Ave, Tahlequah, OK 74464-4717 | 2019-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184253403 | Kendall Harris | Student in an Organized Health Care Education/Training Program | 100 Bliss Ave, Tahlequah, OK 74464 | 2020-04-07 |
| 1528609302 | Norma Brightly | Technician | 103 Sequoyah, Tahlequah, OK 74464 | 2019-10-03 |
| 1073175832 | Jody Lynn Dallis | Case Manager/Care Coordinator | Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 | 2019-07-02 |
| 1184287849 | Perry Jake Proctor | Student in an Organized Health Care Education/Training Program | 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 | 2019-04-18 |
| 1336657279 | Sidney Sheyenne Kimble | Case Manager/Care Coordinator | 1429 Jack Brown Lane, Tahlequah, OK 74464 | 2018-01-12 |
| 1891225686 | Nichols Bradley Alberty | Orthotist | 1294 East Downing, Suite 3, Tahlequah, OK 74464 | 2017-06-14 |
| 1922549690 | Krystal Easter Ms, Lpc | Counselor | 2201 Oakridge Dr, Tahlequah, OK 74464 | 2017-03-15 |
| 1144777319 | Northeastern Oklahoma Community Health Centers, Inc. | Clinic/Center | 529 N. Oak St., Tahlequah, OK 74464 | 2016-09-06 |
| 1548713456 | Clement Isioma Nwadozi | Optometrist | 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 | 2016-07-27 |
| 1033532635 | Wesley Gragg | Specialist/Technologist | 603 North Grand Avenue, Tahlequah, OK 74464 | 2014-02-03 |
| Find all providers in zip 74464 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164968897 | Sandra Shomo | Licensed Practical Nurse | 100 S Bliss Ave, Tahlequah, OK 74464-2512 | 2017-01-19 |
| 1467833434 | Kelly Hopkins | Licensed Practical Nurse | 15481 N Jarvis Rd, Tahlequah, OK 74464-0233 | 2015-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777634 | Karen Ann Crosby | Licensed Practical Nurse | 205 E Ninth St, Wright City, OK 74766 | 2020-10-12 |
| 1013514504 | Tammie Renee Langford | Licensed Practical Nurse | 417952 E 1910 Rd, Antlers, OK 74523-7441 | 2020-10-07 |
| 1033722145 | Karen Gail Nickels | Licensed Practical Nurse | 29408 S 548 Rd, Cookson, OK 74427-2423 | 2020-08-28 |
| 1942825872 | Larita Leake | Licensed Practical Nurse | 10404 Vineyard Blvd Ste C, Oklahoma City, OK 73120-3739 | 2020-06-16 |
| 1568028355 | Kimberly Dawn Richardson | Licensed Practical Nurse | 9213 Ne 10th St, Midwest City, OK 73130-1317 | 2019-05-16 |
| 1265992515 | Jacqueline Chanthay Williams | Licensed Practical Nurse | 1323 E Ash St, Altus, OK 73521-2908 | 2019-03-22 |
| 1114484623 | Sabrina Susie Rocha | Licensed Practical Nurse | 9811 E 12th St, Tulsa, OK 74128-3803 | 2019-02-21 |
| 1689130593 | Georgia Delain Lowe | Licensed Practical Nurse | Route 6 Number 840, Stilwell, OK 74960 | 2019-02-15 |
| 1750845145 | Traci L Carrier | Licensed Practical Nurse | 115 S Lincoln St., Mangum, OK 73554 | 2019-01-30 |
| 1003388497 | Katrina Ann Bush | Licensed Practical Nurse | 1721 E Omaha St Apt B3, Broken Arrow, OK 74012-0363 | 2018-12-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.