Provider Demographics
NPI:1639927171
Name:SEWARD, BRANDY NICOLE
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:NICOLE
Last Name:SEWARD
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 1:7635 E PRAIRIE GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6850
Mailing Address - Country:US
Mailing Address - Phone:580-485-7825
Mailing Address - Fax:
Practice Address - Street 1:2701 W I 44 SERVICE RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-3775
Practice Address - Country:US
Practice Address - Phone:866-848-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist