Healthcare Provider Details
I. General information
NPI: 1326324195
Provider Name (Legal Business Name): LEIGHANN MORRILL BROWN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/25/2011
Last Update Date: 11/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3366 NW EXPRESSWAY SUITE 200
OKLAHOMA CITY OK
73112-4462
US
IV. Provider business mailing address
5300 N INDEPENDENCE AVE SUITE 280
OKLAHOMA CITY OK
73112-5556
US
V. Phone/Fax
- Phone: 405-713-9930
- Fax: 405-713-9931
- Phone: 405-713-9930
- Fax: 405-713-9931
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SC0200X |
| Taxonomy | Critical Care Medicine Clinical Nurse Specialist |
| License Number | 47684 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SA2100X |
| Taxonomy | Acute Care Clinical Nurse Specialist |
| License Number | 47684 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: