Provider Demographics
NPI:1447487764
Name:BLOCK, INGRID LAUB (RN, MS, CNS)
Entity type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:LAUB
Last Name:BLOCK
Suffix:
Gender:F
Credentials:RN, MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SL YOUNG
Mailing Address - Street 2:WP 2410
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5033
Mailing Address - Country:US
Mailing Address - Phone:405-271-8777
Mailing Address - Fax:405-271-6275
Practice Address - Street 1:920 SL YOUNG
Practice Address - Street 2:WP 2410
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5033
Practice Address - Country:US
Practice Address - Phone:405-271-8777
Practice Address - Fax:405-271-6275
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0059925163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology