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NPI Code Detail

MEDICARE: MRS. BIANCA LESHAY BRAXTON APRN

MEDICARE:  MRS. BIANCA LESHAY BRAXTON  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
1363LF0000XFamily Nurse Practitioner98084OK

General Provider Information

NPI Number : 1952765554
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BIANCA LESHAY BRAXTON APRN
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 : 405-758-5354
Provider Business Practice Location Address
First Line : 2000 ANN BRANDEN BLVD STE 201
Second Line :
City : NORMAN
State : OK
Zip : 73071-1667
Country : US
Telephone Number : 405-515-0520
Fax Number : 405-307-5650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2016
Last Update Date : 08/02/2023

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Directions to “ MRS. BIANCA LESHAY BRAXTON APRN” Practice Location

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