Individual
MRS. BRENDA LEE PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P. & C.P.N.P.
Contact information
Practice address
415 FAIRVIEW AVE STE 100, PONCA CITY, OK 74601-1923
(580) 765-5569
(580) 765-2020
Mailing address
415 FAIRVIEW AVE STE 100, PONCA CITY, OK 74601-1923
(580) 765-5569
(580) 765-2020
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R0047728
OK
Other
Enumeration date
01/23/2007
Last updated
07/09/2007
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