Provider Demographics
NPI:1649737172
Name:LEBLANC, RYLEE NIKOLE (BSN-RN)
Entity Type:Individual
Prefix:
First Name:RYLEE
Middle Name:NIKOLE
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:BSN-RN
Other - Prefix:
Other - First Name:RYLEE
Other - Middle Name:NIKOLE
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1119 S HIGH SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-8233
Mailing Address - Country:US
Mailing Address - Phone:580-279-2183
Mailing Address - Fax:
Practice Address - Street 1:1119 S HIGH SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820
Practice Address - Country:US
Practice Address - Phone:580-279-2183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator