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NPI Code Detail

MEDICARE: BRIANNA DAVID APRN

MEDICARE: BRIANNA DAVID APRN
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
1363LW0102XWomen's Health Nurse Practitioner851718TX
2363LW0102XWomen's Health Nurse Practitioner009978OK

Other Identifiers

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

General Provider Information

NPI Number : 1356766315
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA DAVID APRN
Provider Business Mailing Address
First Line : 916 N MAIN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-3118
Country : US
Telephone Number : 580-379-3132
Fax Number : 580-379-3137
Provider Business Practice Location Address
First Line : 916 N MAIN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-3118
Country : US
Telephone Number : 580-379-3132
Fax Number : 580-379-3137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2014
Last Update Date : 10/25/2022

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