Desiree Briana Bryant, LPN

Individual provider Active NPI Licensed Practical Nurse · Wynnewood, OK

NPI 1306335773 · NPPES record last updated May 1, 2018

Key facts

NPI
1306335773
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
59160 (OK)
Practice address
116 E Robert S Kerr Blvd
Wynnewood, OK 73098-6621
Phone
(405) 665-4351
Fax
(405) 665-6372
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
59160OKMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wynnewood Urgent Care and Immediate Care Center PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 59160 OK Yes

Addresses

Primary practice location

116 E Robert S Kerr Blvd
Wynnewood, OK 73098-6621

Mailing address

116 E Robert S Kerr Blvd
Wynnewood, OK 73098-6621
Phone (405) 665-4351

Other practice location 1

106 N Powell Ave
Wynnewood, OK 73098-6608
Phone (405) 665-1010

Other providers in Wynnewood, OK

All providers in Wynnewood, OK · Licensed Practical Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.