Provider Demographics
NPI:1891268629
Name:BRISENO, DANIELLE TORRES (APRN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:TORRES
Last Name:BRISENO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 NORMANDY RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1763
Mailing Address - Country:US
Mailing Address - Phone:405-514-7231
Mailing Address - Fax:
Practice Address - Street 1:3905 NORMANDY RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-1763
Practice Address - Country:US
Practice Address - Phone:405-514-7231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK85994163WE0003X
OK85944363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WE0003XNursing Service ProvidersRegistered NurseEmergency