MEDICARE: MRS. MANDI L BROWN ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	R0075445	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033156096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MANDI L BROWN ARNP

Provider Business Mailing Address
First Line	:	PO BOX 1330
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73070-1330
Country	:	US
Telephone Number	:	405-307-6668
Fax Number	:

Provider Business Practice Location Address
First Line	:	14800 S WESTERN AVE STE A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-7107
Country	:	US
Telephone Number	:	405-515-0330
Fax Number	:	405-307-5662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/30/2021

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