MRS. NICHOLETTE BROSSEAU (NPI# 1720639263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720639263 |
Entity Type | Individual |
Full Name | MRS. NICHOLETTE BROSSEAU |
Practice Address |
1520 Sw 1st St Wagoner OK 74467-4839 |
Mailing Address |
5130 S Hudson Pl Tulsa OK 74135-7509 |
Practice Telephone | 9187047825 |
Mailing Telephone | 9187047825 |
Enumeration Date | 2019-09-25 |
Last Update Date | 2020-11-09 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
5130 S Hudson Pl, Tulsa, OK 741357509 | 9187047825 |
Street Address |
1520 SW 1ST ST |
City | WAGONER |
State | OK |
Zip Code | 74467-4839 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982251591 | Alesha Lenard | Behavior Technician | 901 S. Harrill Ave, Wagoner, OK 74467 | 2019-08-20 |
1679030597 | Lorri Dawn Pitchford | Case Manager/Care Coordinator | Creoks Behavioral Health Services, 109 S Harrill Ave., Wagoner, OK 74467 | 2019-02-27 |
1144769399 | Elaina Murray | Technician | 308 Ne 2nd St., Wagoner, OK 74467 | 2017-02-21 |
1336699784 | Tommye Evidson | Counselor | 109 Harrill Ave, Wagoner, OK 74467 | 2016-10-10 |
1518327857 | Yco Tulsa, Inc | Clinic/Center | 1101a South Mcquarrie, Wagoner, OK 74467 | 2016-02-29 |
1396117545 | Sandra Cooper | Behavioral Analyst | 2109 Us-69, Wagoner, OK 74467 | 2015-10-28 |
1588051486 | Penny Nye | Counselor | 2109 S.hwy 69, Wagoner, OK 74467 | 2015-04-20 |
1376943571 | Justin F Kurtz | Respiratory Therapist, Certified | 1200 W. Cherokee, Suite H Cardiac/pulmonary Rehab, Wagoner, OK 74467 | 2014-08-26 |
1780009969 | David H Good | Family Medicine | 1202 W. Cherokee St, Ste E, Wagoner, OK 74467 | 2014-02-25 |
1942598875 | Robin Rodriguez-higginbottom | Speech-Language Pathologist | 215 E Cherokee St, Wagoner, OK 74467 | 2011-07-12 |
Find all providers in zip 74467 |
Taxonomy Code | 261QU0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Urgent Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871120022 | Urgent Care of Muskogee Pllc | Clinic/Center | 1317 S Dewey Ave, Wagoner, OK 74467-7013 | 2020-03-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902426737 | Creekside Urgent Care LLC | Clinic/Center | 1101 Nw 178th St Ste B, Edmond, OK 73012-4281 | 2020-04-22 |
1629604434 | Medwise LLC | Clinic/Center | 11495 S. State Highway 51, Coweta, OK 74429 | 2020-03-13 |
1831722982 | Sooner Urgent Care LLC | Clinic/Center | 2100 W Lindsey St Ste B, Norman, OK 73069-4108 | 2020-02-18 |
1548819477 | Christi Lea Vick | Clinic/Center | 704 Azalea Hill Dr, Yukon, OK 73099-6504 | 2019-09-04 |
1447805544 | Revive Medical Urgent Care LLC | Clinic/Center | 4215 N Classen Blvd Ste 100, Oklahoma City, OK 73118-2426 | 2019-08-06 |
1780239202 | Immediate Care of Oklahoma, LLC | Clinic/Center | 10616 U.S. Highway 66, Suite 100, Oklahoma City, OK 73099 | 2019-08-02 |
1982161386 | On Demand Urgent Care, LLC | Clinic/Center | 11426 N 134th E Ave, Owasso, OK 74055-5755 | 2019-02-22 |
1720554231 | Gdn LLC | Clinic/Center | 1315 Chisholm Trail Pkwy, Duncan, OK 73533-1533 | 2018-10-23 |
1699262576 | Immediate Care of Oklahoma, LLC | Clinic/Center | 4500 Tinker Rd, Oklahoma City, OK 73135-4614 | 2018-04-17 |
1992292999 | Immediate Care of Oklahoma, LLC | Clinic/Center | 10551 Se 59th St, Oklahoma City, OK 73150-4302 | 2018-04-16 |
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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.