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General NPI Number Information
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NPI Number | 1578458550
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Entity Type | Individual
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Provider Name | MARY DANIELLE BRANSON APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 160 E SW 59TH ST
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City | MUSTANG
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State | OK
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Zip | 73064-4722
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Country | US
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Telephone | 903-340-5187
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 891265
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City | OKLAHOMA CITY
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State | OK
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Zip | 73189-1265
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Country | US
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Telephone | 405-757-7818
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 222482
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License Number State | OK
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