Individual
LISA BROOKE RENFROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2809 CIRCLE DR, MUSKOGEE, OK 74403-6020
(918) 360-3794
Mailing address
2809 CIRCLE DR, MUSKOGEE, OK 74403-6020
(918) 360-3794
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0080011
OK
390200000X
Student in an Organized Health Care Education/Training Program
R0080011
OK
Other
Enumeration date
03/06/2017
Last updated
08/02/2017
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