Healthcare Provider Details

I. General information

NPI: 1003362658
Provider Name (Legal Business Name): BRANDI BYBEE APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N BRYANT AVE STE 120
EDMOND OK
73034-6291
US

IV. Provider business mailing address

200 N BRYANT AVE STE 120
EDMOND OK
73034-6291
US

V. Phone/Fax

Practice location:
  • Phone: 405-832-6881
  • Fax:
Mailing address:
  • Phone: 405-832-6881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number96474
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number96474
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number96474
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: