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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, April 24, 2024 3:08 PM CDT
Next Update: Thursday, April 25, 2024 2:50 AM CDT

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TERRY, BLAIR NICOLE
Practice Address: 5401 N. PORTLAND AVE
OKLAHOMA CITY OK 73112-2090

Address last updated on 2/5/2024
Phone #: (405) 713-9940
Fax #:
County: OKLAHOMA
License: 2922
Dated: 6/21/2018
Expires: 3/31/2025
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
5401 N. PORTLAND AVE
OKLAHOMA CITY OK 73112-2090

Phone #: (405) 713-9940
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
JAMES JASON JACKSON MD 27258
JAMES CALVIN JOHNSON MD 15302
GERARDO MORALES MYRIN MD 33739

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