Provider Demographics
NPI:1003591678
Name:COLLIER, RYLEIGH BLAIR
Entity Type:Individual
Prefix:
First Name:RYLEIGH
Middle Name:BLAIR
Last Name:COLLIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N OAK AVE
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73090-9612
Mailing Address - Country:US
Mailing Address - Phone:405-659-4624
Mailing Address - Fax:
Practice Address - Street 1:600 S CHOCTAW AVE
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036
Practice Address - Country:US
Practice Address - Phone:405-422-6327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0133129163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse