Healthcare Provider Details

I. General information

NPI: 1437444114
Provider Name (Legal Business Name): BRANDI LYNN COREY L.M., C.P.M., R.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRANDI LYNN STONE LM, CPM, RPT

II. Dates (important events)

Enumeration Date: 06/10/2011
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3309 S YALE AVE
TULSA OK
74135-8011
US

IV. Provider business mailing address

3309 S YALE AVE
TULSA OK
74135-8011
US

V. Phone/Fax

Practice location:
  • Phone: 918-344-0945
  • Fax: 918-856-3759
Mailing address:
  • Phone: 918-344-0945
  • Fax: 918-856-3759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberOKMIDW0018
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: