Healthcare Provider Details

I. General information

NPI: 1003666710
Provider Name (Legal Business Name): BRITTANY RAYMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 N GREENWOOD AVE STE 131
TULSA OK
74120-1444
US

IV. Provider business mailing address

723 S KNOXVILLE AVE
TULSA OK
74112-3841
US

V. Phone/Fax

Practice location:
  • Phone: 918-599-7277
  • Fax:
Mailing address:
  • Phone: 614-619-3953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberLPCCANDIDATE12990
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: