Provider Demographics
NPI:1790467421
Name:BRAMLETT, RENE LEVETTE
Entity Type:Individual
Prefix:MISS
First Name:RENE
Middle Name:LEVETTE
Last Name:BRAMLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 W 11TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-9034
Mailing Address - Country:US
Mailing Address - Phone:918-282-8716
Mailing Address - Fax:
Practice Address - Street 1:607 W 11TH ST APT 1
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-9034
Practice Address - Country:US
Practice Address - Phone:918-282-8716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKK000078786172A00000X, 343900000X, 347C00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
No172A00000XOther Service ProvidersDriver
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle