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Individual
TINA MARGARET BRANNON
Active
Individual
TINA MARGARET BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, BS
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
L OO17786
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
453004024
LPN L 0017786
OK
Enumeration date
01/09/2012
Last updated
01/09/2012
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