Healthcare Provider Details

I. General information

NPI: 1609479211
Provider Name (Legal Business Name): MARY ANN CAROLINE BROWNING APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

1200 CHILDRENS AVE
OKLAHOMA CITY OK
73104-4637
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-2387
  • Fax: 405-271-2281
Mailing address:
  • Phone: 405-271-2387
  • Fax: 405-271-2281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number200278
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: