Healthcare Provider Details

I. General information

NPI: 1043172505
Provider Name (Legal Business Name): BRANDALYN KAYE APPLE MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3605 JOSHUA LN
MOORE OK
73165-5002
US

IV. Provider business mailing address

3605 JOSHUA LN
MOORE OK
73165-5002
US

V. Phone/Fax

Practice location:
  • Phone: 405-830-3228
  • Fax:
Mailing address:
  • Phone: 405-830-3228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberR0132812
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: