Provider Demographics
NPI:1720476484
Name:LEMBKE, BRANDY C (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:C
Last Name:LEMBKE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5209 REDBUD DR
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3237
Mailing Address - Country:US
Mailing Address - Phone:918-698-8028
Mailing Address - Fax:
Practice Address - Street 1:3905 S HIGHWAY 97
Practice Address - Street 2:#B
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3829
Practice Address - Country:US
Practice Address - Phone:918-245-7500
Practice Address - Fax:918-245-7506
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR 0083615163W00000X
OK83615363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse