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Individual

MRS. TERRINA ROMELLE BRASHEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1015 W WASHBOURNE ST, JAY, OK 74346-4205
(918) 253-4271
(918) 253-2531
Mailing address
1015 W WASHBOURNE ST, P.O. BOX 350, JAY, OK 74346-4205
(918) 253-4271
(918) 253-2531

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2000172822
MO
363LF0000X
Family Nurse Practitioner
Primary
73174
OK
363LF0000X
Family Nurse Practitioner
A03020 ANP
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
166818758
AR
05
1922299072
MO
05
200127960A
OK
Enumeration date
08/05/2007
Last updated
07/17/2013
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