Organization
BPEIXOTTO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE ALLEN PEIXOTTO FNP-BC (OWNER)
(918) 607-8426
Entity
Organization
Contact information
Practice address
7009 S PEACH AVE, BROKEN ARROW, OK 74011-5811
(918) 607-8426
Mailing address
7009 S PEACH AVE, BROKEN ARROW, OK 74011-5811
(918) 607-8426
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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