Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | OK |
NPI | 1134778111 |
---|---|
Provider Name | Brandy R Harris |
First Address | Yukon, OK 73099-8211 |
Second Address | Yukon, OK 73099-8211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2019 |
Last Update Date | 11/09/2019 |