Individual
MRS. BRENDA ELDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
1001 SO. 41ST ST. EAST, MUSKOGEE, OK 74403-1404
(918) 687-0201
(918) 687-0665
Mailing address
23778 S MITCHELL LANE, FORT GIBSON, OK 74434
(918) 478-4394
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
R0051899
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1751899
—
OK
Enumeration date
10/04/2005
Last updated
03/03/2008
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