Individual
MRS. TONIA RENE'E BRANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IPP/CNA
Contact information
Practice address
RR 3 BOX 152A, MCALESTER, OK 74501-9514
(918) 470-0959
Mailing address
PO BOX 36, SAVANNA, OK 74565-0036
(918) 470-0959
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
200126080A
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200126080
—
OK
Enumeration date
05/03/2008
Last updated
05/03/2008
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