Healthcare Provider Details

I. General information

NPI: 1548628795
Provider Name (Legal Business Name): BRAIN & NERVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 N. HUDSON AVE SUITE NUMBER 9
OKLAHOMA CITY OK
73116
US

IV. Provider business mailing address

PO BOX 893076
OKLAHOMA CITY OK
73189
US

V. Phone/Fax

Practice location:
  • Phone: 405-769-7241
  • Fax: 405-769-7241
Mailing address:
  • Phone: 405-834-0893
  • Fax: 405-769-7241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MS. PATRICE A COOK
Title or Position: CEO
Credential: REEGT
Phone: 405-834-0893