Individual
BRANDY PONDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1000
Mailing address
4913 W RENO AVE, OKLAHOMA CITY, OK 73127-6339
(405) 948-4900
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
106622
OK
Other
Enumeration date
06/25/2020
Last updated
03/11/2022
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