Provider Demographics
NPI:1548628795
Name:BRAIN & NERVE INC
Entity type:Organization
Organization Name:BRAIN & NERVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:A
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:REEGT
Authorized Official - Phone:405-834-0893
Mailing Address - Street 1:PO BOX 893076
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73189
Mailing Address - Country:US
Mailing Address - Phone:405-834-0893
Mailing Address - Fax:405-769-7241
Practice Address - Street 1:7700 N. HUDSON AVE
Practice Address - Street 2:SUITE NUMBER 9
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116
Practice Address - Country:US
Practice Address - Phone:405-769-7241
Practice Address - Fax:405-769-7241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
OK251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No282N00000XHospitalsGeneral Acute Care Hospital