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General NPI Number Information
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NPI Number | 1437078912
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Entity Type | Individual
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Provider Name | BRINKLEE DELAINEY MIXON SA-C, CST
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Gender | Female
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 110 NW 31ST ST FL 3
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City | LAWTON
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State | OK
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Zip | 73505-6100
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Country | US
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Telephone | 580-510-7042
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73505-6332
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Country | US
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Telephone | 580-357-3671
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 26-272
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License Number State | OK
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