Provider Demographics
NPI:1336887066
Name:PRATER-BLOUNT, ERIN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:PRATER-BLOUNT
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W 33RD ST # 8282
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3811
Mailing Address - Country:US
Mailing Address - Phone:405-916-9972
Mailing Address - Fax:405-888-8765
Practice Address - Street 1:1324 LAPWING RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-4829
Practice Address - Country:US
Practice Address - Phone:405-850-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0113906163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant