Individual
BRENDA ILENE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401-1318
(918) 577-3520
Mailing address
11280 W 805 RD, FORT GIBSON, OK 74434-6399
(918) 231-7118
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0059834
OK
Other
Enumeration date
05/21/2025
Last updated
05/21/2025
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