Healthcare Provider Details

I. General information

NPI: 1780996538
Provider Name (Legal Business Name): BRANDI M SCHMIT MT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2026 E HWY 152 103
MUSTANG OK
73064
US

IV. Provider business mailing address

317 E MOBILE TER
MUSTANG OK
73064-6524
US

V. Phone/Fax

Practice location:
  • Phone: 405-613-2066
  • Fax:
Mailing address:
  • Phone: 405-613-2066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: