Basic Information
| Provider Information | |||||||||
| NPI: | 1548628795 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BRAIN & NERVE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 893076 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058340893 | ||||||||
| FaxNumber: | 4057697241 | ||||||||
| Practice Location | |||||||||
| Address1: | 7700 N. HUDSON AVE | ||||||||
| Address2: | SUITE NUMBER 9 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057697241 | ||||||||
| FaxNumber: | 4057697241 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2016 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | COOK | ||||||||
| AuthorizedOfficialFirstName: | PATRICE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4058340893 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | REEGT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | N | Hospitals | General Acute Care Hospital | 251G00000X | OK | Y | Agencies | Hospice Care, Community Based |
No ID Information.