Individual
BROOKE L MINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
27 E ROSS STREET, SAPULPA, OK 74066
(918) 216-4999
Mailing address
1709 N 5TH ST, HENRYETTA, OK 74437-1611
(918) 944-9795
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201128
OK
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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