Provider Demographics
NPI:1992989511
Name:BLACKBURN, KAREN ANN (IBCLC,RLC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:ANN
Last Name:BLACKBURN
Suffix:
Gender:F
Credentials:IBCLC,RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 SW 129TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6999
Mailing Address - Country:US
Mailing Address - Phone:405-473-2721
Mailing Address - Fax:405-270-7558
Practice Address - Street 1:1000 N LEE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1036
Practice Address - Country:US
Practice Address - Phone:405-272-6207
Practice Address - Fax:405-270-7558
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist