Healthcare Provider Details

I. General information

NPI: 1073444584
Provider Name (Legal Business Name): BROOKE DAUGHERTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 NE 10TH ST
OKLAHOMA CITY OK
73104-5418
US

IV. Provider business mailing address

800 NE 10TH ST
OKLAHOMA CITY OK
73104-5418
US

V. Phone/Fax

Practice location:
  • Phone: 572-244-0108
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License NumberR-18438
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: