Provider Demographics
NPI:1447095989
Name:BASCUE, BRITTANY ANN (ANMT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ANN
Last Name:BASCUE
Suffix:
Gender:F
Credentials:ANMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 SEARAY LN APT 202
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-2632
Mailing Address - Country:US
Mailing Address - Phone:918-998-4825
Mailing Address - Fax:
Practice Address - Street 1:1107 E 13TH ST STE A
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7956
Practice Address - Country:US
Practice Address - Phone:918-786-8834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK180929174H00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174H00000XOther Service ProvidersHealth Educator