Provider Demographics
NPI:1508496803
Name:CREWS, BRIANNE KIRCHGESSNER (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:KIRCHGESSNER
Last Name:CREWS
Suffix:
Gender:F
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-2833
Mailing Address - Country:US
Mailing Address - Phone:309-846-5388
Mailing Address - Fax:
Practice Address - Street 1:11 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-6821
Practice Address - Country:US
Practice Address - Phone:918-542-4444
Practice Address - Fax:918-542-4441
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD16302183500000X
KS1-118312183500000X
OKI-10067390200000X
OK19753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program