Individual
BRADLEY MAPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 W GORE BLVD, LAWTON, OK 73505-6332
(580) 355-8620
Mailing address
7360 MERCY LN, HICKMAN, NE 68372-9528
(405) 351-3501
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
100017
OK
163W00000X
Registered Nurse
77627
NE
367500000X
Certified Registered Nurse Anesthetist
Primary
100017
OK
Other
Enumeration date
03/03/2017
Last updated
05/26/2017
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