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1073020988
LEA DOMENIQUE BRYAN
EDMOND, OK
NPI
1073020988
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: PA SPO18291)
Enumeration Date
2018-01-02
Last Update Date
2023-07-18
Business Address
LEA DOMENIQUE BRYAN CRNP
1705 RENAISSANCE BLVD
EDMOND, OK 73013-3041
Phone number: 405-844-4978
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Mailing Address
LEA DOMENIQUE BRYAN CRNP
1701 RENAISSANCE BLVD
EDMOND, OK 73013-3086
Phone number: 405-844-4978
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