Healthcare Provider Details

I. General information

NPI: 1659137297
Provider Name (Legal Business Name): SHELLEY BRAUER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 SPRINGER DR STE 300
NORMAN OK
73069-3966
US

IV. Provider business mailing address

2424 SPRINGER DR STE 102
NORMAN OK
73069-3966
US

V. Phone/Fax

Practice location:
  • Phone: 405-216-3747
  • Fax: 405-339-0377
Mailing address:
  • Phone: 405-216-3747
  • Fax: 405-339-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number217705
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF01240127
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: