Provider Demographics
NPI:1205215969
Name:BRIGMAN, DEBORA
Entity Type:Individual
Prefix:
First Name:DEBORA
Middle Name:
Last Name:BRIGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:SCHULTER
Mailing Address - State:OK
Mailing Address - Zip Code:74460-0109
Mailing Address - Country:US
Mailing Address - Phone:918-521-7738
Mailing Address - Fax:
Practice Address - Street 1:21825 S 246 ROAD
Practice Address - Street 2:
Practice Address - City:SCHULTER
Practice Address - State:OK
Practice Address - Zip Code:74460-0109
Practice Address - Country:US
Practice Address - Phone:918-521-7738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54076164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse