Individual
MS. DIANE DEWBRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
GNP-BC
Contact information
Practice address
128 W MAIN ST, PURCELL, OK 73080-4220
(405) 527-4704
(405) 427-5976
Mailing address
128 W MAIN ST, PURCELL, OK 73080-4220
(405) 527-4704
(405) 427-5976
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
49456
OK
363LG0600X
Gerontology Nurse Practitioner
547215
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20053303A
—
OK
Enumeration date
12/18/2007
Last updated
09/09/2015
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