Healthcare Provider Details

I. General information

NPI: 1396098059
Provider Name (Legal Business Name): MARLENE ANGELA BROWN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: M. ANGELA BROWN APRN-CNP

II. Dates (important events)

Enumeration Date: 10/18/2012
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 NW 5TH ST
GUYMON OK
73942-4204
US

IV. Provider business mailing address

212 NW 5TH ST
GUYMON OK
73942-4204
US

V. Phone/Fax

Practice location:
  • Phone: 580-338-7462
  • Fax: 580-297-9105
Mailing address:
  • Phone: 580-338-7462
  • Fax: 580-297-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number89143
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberC-APN.0102486-C-NP
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53-82919-0042
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1171151
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number83181
License Number StateNM
# 6
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number216007
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: