Provider Demographics
NPI:1659378735
Name:BRAHM, NANCY C (PHARMD, MS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:C
Last Name:BRAHM
Suffix:
Gender:F
Credentials:PHARMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2553
Mailing Address - Country:US
Mailing Address - Phone:918-660-3579
Mailing Address - Fax:918-660-3009
Practice Address - Street 1:4502 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2553
Practice Address - Country:US
Practice Address - Phone:918-660-3579
Practice Address - Fax:918-660-3009
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK110541835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric