Provider Demographics
NPI:1306822085
Name:BROWN, NANCY B (PT)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:B
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:K
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2217 W SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-2009
Mailing Address - Country:US
Mailing Address - Phone:580-252-3464
Mailing Address - Fax:
Practice Address - Street 1:1503 BROOKWOOD AVE
Practice Address - Street 2:C
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1363
Practice Address - Country:US
Practice Address - Phone:580-252-2567
Practice Address - Fax:580-252-2568
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT585225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731241393001OtherBCBS