Healthcare Provider Details

I. General information

NPI: 1902582828
Provider Name (Legal Business Name): BRITTANY TOHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY WELLS

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N MAIN
KINGFISHER OK
73750
US

IV. Provider business mailing address

P.O. BOX 372
KINGFISHER OK
73047
US

V. Phone/Fax

Practice location:
  • Phone: 405-424-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212027
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: