Individual
BRADAN MILLER O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
301 S J T STITES ST, SALLISAW, OK 74955-9302
(918) 775-9150
Mailing address
2817 IRVING ST, MUSKOGEE, OK 74403-3934
(918) 348-1066
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0126877
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2020
Last updated
08/07/2020
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