Individual
BRIAN MARK BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
605 REDSTONE AVE, EDMOND, OK 73013-5915
(405) 204-1090
Mailing address
605 REDSTONE AVE, EDMOND, OK 73013-5915
(405) 204-1090
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0069574
OK
Other
Enumeration date
02/23/2026
Last updated
02/23/2026
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