Provider Demographics
NPI:1295474021
Name:PRESCOTT, BRIANNA MARIE (OD)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:MARIE
Last Name:PRESCOTT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:MARIE
Other - Last Name:FRANZEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8121 NATIONAL AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7572
Mailing Address - Country:US
Mailing Address - Phone:405-737-8935
Mailing Address - Fax:405-737-8934
Practice Address - Street 1:8121 NATIONAL AVE STE 409
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7572
Practice Address - Country:US
Practice Address - Phone:405-737-8935
Practice Address - Fax:405-737-8934
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3194152W00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program