Provider Demographics
NPI:1467113340
Name:BRINGMAN, MONIQUE M
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:M
Last Name:BRINGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MONIQUE
Other - Middle Name:M
Other - Last Name:MEADOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1503 W GORE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3608
Mailing Address - Country:US
Mailing Address - Phone:580-730-0232
Mailing Address - Fax:
Practice Address - Street 1:1503 W GORE BLVD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3608
Practice Address - Country:US
Practice Address - Phone:580-730-0232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator