Provider Demographics
NPI:1316590714
Name:RICHARDS, BRENDA KAY (APRN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:KAY
Other - Last Name:BAINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 825
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74013-0825
Mailing Address - Country:US
Mailing Address - Phone:918-261-4053
Mailing Address - Fax:
Practice Address - Street 1:4870 S LEWIS AVE STE 240
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5153
Practice Address - Country:US
Practice Address - Phone:918-982-6524
Practice Address - Fax:539-399-7559
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK109700363LP0808X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice