MEDICARE: NANCY J. BRAWNER MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0156	OK

General Provider Information

NPI Number	:	1144216540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY J. BRAWNER MSW

Provider Business Mailing Address
First Line	:	5013 NW 61ST PL
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73122-7410
Country	:	US
Telephone Number	:	405-721-8829
Fax Number	:	405-721-8921

Provider Business Practice Location Address
First Line	:	5013 NW 61ST PL
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73122-7410
Country	:	US
Telephone Number	:	405-721-8829
Fax Number	:	405-721-8921

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	07/08/2007

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