Individual
BRENDA HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
908 19TH ST, WOODWARD, OK 73801-2307
(580) 254-3396
(580) 256-1731
Mailing address
908 19TH ST, WOODWARD, OK 73801-2307
(580) 254-3396
(580) 256-1731
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
47494
OK
363LF0000X
Family Nurse Practitioner
R0047494
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100146050
—
OK
Enumeration date
06/26/2006
Last updated
10/21/2020
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