Individual
BETHANY SPAINE BROWDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
117 E RAY FINE BLVD, ROLAND, OK 74954-5198
(918) 427-3344
Mailing address
924 QUINCY ST, FORT SMITH, AR 72901-7820
(479) 395-7594
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0068268
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200879420N
MEDICAL GROUP
—
Enumeration date
03/07/2023
Last updated
03/08/2023
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