BRADEN PETERSON (NPI# 1245762020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245762020 |
| Entity Type | Individual |
| Full Name | BRADEN PETERSON |
| Credential | APRN-BC |
| Practice Address |
6814 Nw 23rd St Bethany OK 73008-5217 |
| Mailing Address |
3609 Carnoustie Dr Norman OK 73072-1947 |
| Practice Telephone | 4056031175 |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2017-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
90405 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6814 NW 23RD ST |
| City | BETHANY |
| State | OK |
| Zip Code | 73008-5217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780150151 | Kimberly Campbell | Counselor | 6612 Nw 42nd Street, Bethany, OK 73008 | 2018-10-23 |
| 1366943151 | Arkansas Liver and Gastroenterology, Pa | Clinic/Center | 2347 North Thompkins Ave, Bethany, OK 73008 | 2018-02-27 |
| 1881106805 | Tiffany Harmon | Physical Therapy Assistant | 6729 Nw 39th Exp., Sawyer Center, Bethany, OK 73008 | 2017-10-31 |
| 1740660257 | Michael Brobston | Specialist | 6729 Nw 39th Expressway, Bethany, OK 73008 | 2015-06-01 |
| 1043626120 | Danielle Manning | Case Manager/Care Coordinator | 6729 Nw Expressway, Bethany, OK 73008 | 2014-07-09 |
| 1487065157 | Carolyn Mgcdf Jones | Behavioral Analyst | 2209 Nth. Beaver Ave., Bethany, OK 73008 | 2014-05-15 |
| 1013327022 | Ephraim Kelley | Counselor | 2800 N. Rockwell Ave., Bethany, OK 73008 | 2014-04-29 |
| 1356600407 | Mallory Crosier | Occupational Therapist | 6800 Nw 39th Expresswaay, Bethany, OK 73008 | 2012-05-10 |
| 1326310897 | Isaac I Juarez | Psychologist | 2020 N Briarcliff Ave., Bethany, OK 73008 | 2012-01-31 |
| 1295015295 | Lauren Vanderloo | Counselor | 7908 Northwest 23rd St, Bethany, OK 73008 | 2011-08-22 |
| Find all providers in zip 73008 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831639392 | Tatiana A. Goclowski | Nurse Practitioner | 187 Beacon Rd, Bethany, CT 06524-3054 | 2017-03-03 |
| 1720301575 | Valerie Ann Bell | Nurse Practitioner | 438 Ash St, Bethany, PA 18431-4015 | 2010-03-08 |
| 1699948646 | Saints Medical Group, LLC | Nurse Practitioner | 7101 Nw 23rd St, Bethany, OK 73008-5159 | 2008-04-10 |
| 1295353506 | Adele Burt | Nurse Practitioner | 6800 Nw 39th Expy, Bethany, OK 73008-2513 | 2020-07-13 |
| 1861026254 | David Mathew | Nurse Practitioner | 6800 Nw 39th Expy, Bethany, OK 73008-2513 | 2020-02-25 |
| 1013570035 | Amaza Tripp | Nurse Practitioner | 7530 Nw 23rd St, Bethany, OK 73008-4921 | 2019-04-16 |
| 1649797044 | Zhanjuan Wang | Nurse Practitioner | 6820 Nw 23rd St, Bethany, OK 73008-5217 | 2017-08-25 |
| 1851823587 | Heather Dawn Foster | Nurse Practitioner | 7530 Nw 23rd St, Bethany, OK 73008 | 2017-03-31 |
| 1053856641 | Jessica Wynn Harris | Nurse Practitioner | 6800 Nw 39th Expy, Bethany, OK 73008-2513 | 2017-01-05 |
| 1811432792 | Nafeesah Thompson | Nurse Practitioner | 6800 Nw 39th Expy, Bethany, OK 73008-2513 | 2016-12-30 |
| Find all providers in BETHANY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.