Provider Demographics
NPI:1356648638
Name:PARKER-NUNLEY, BRANDI (MS)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:
Last Name:PARKER-NUNLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23636 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MULHALL
Mailing Address - State:OK
Mailing Address - Zip Code:73063-9565
Mailing Address - Country:US
Mailing Address - Phone:580-641-2510
Mailing Address - Fax:
Practice Address - Street 1:23636 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MULHALL
Practice Address - State:OK
Practice Address - Zip Code:73063-9565
Practice Address - Country:US
Practice Address - Phone:580-641-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731545165Medicaid