Provider Demographics
NPI:1689983553
Name:GOLWAS, BROOKE ELIZABETH (ARNP, MSN)
Entity Type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:GOLWAS
Suffix:
Gender:F
Credentials:ARNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5808
Mailing Address - Country:US
Mailing Address - Phone:918-521-7555
Mailing Address - Fax:
Practice Address - Street 1:1919 S WHEELING AVE STE 300
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5632
Practice Address - Country:US
Practice Address - Phone:918-794-0701
Practice Address - Fax:918-794-0701
Is Sole Proprietor?:No
Enumeration Date:2010-09-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF0910053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF0910053OtherAANP
OKR 78737OtherOK BOARD OF NURSING