Healthcare Provider Details

I. General information

NPI: 1073439972
Provider Name (Legal Business Name): BRETT COLE TAYLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W BOISE CIR
BROKEN ARROW OK
74012-4900
US

IV. Provider business mailing address

5675 N 240 RD
BEGGS OK
74421-2837
US

V. Phone/Fax

Practice location:
  • Phone: 918-994-8000
  • Fax:
Mailing address:
  • Phone: 918-261-8021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number229740
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: