| NPI | 1336820596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITZI BRASSEAUX SAVAGE Nurse Practitioner 405-633-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| 261QV0200X Clinic/Center, VA | |
| Enumeration Date | 2023-07-28 |
| Last Update Date | 2024-10-03 |