Provider Demographics
NPI:1518401942
Name:BRAUDWAY, STEVEN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BRAUDWAY
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-1809
Mailing Address - Country:US
Mailing Address - Phone:405-615-3245
Mailing Address - Fax:
Practice Address - Street 1:937 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-1809
Practice Address - Country:US
Practice Address - Phone:405-615-3245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-04
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0089090163WE0003X
OK89090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency