Brisa Montes

Individual provider Active NPI Licensed Practical Nurse · Alva, OK

NPI 1487220828 · NPPES record last updated May 27, 2021

Key facts

NPI
1487220828
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
200065 (OK)
Practice address
604 Choctaw St
Alva, OK 73717-1626
Phone
(580) 327-1112
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
No

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
200065OKMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 200065 OK Yes

Addresses

Primary practice location

604 Choctaw St
Alva, OK 73717-1626

Mailing address

604 Choctaw St
Alva, OK 73717-1626
Phone (580) 327-1112

Other providers in Alva, OK

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

Sources for this page

Verify at the official NPI Registry.