| Doctor Name: | MRS. BRENDA DAVIS |
| NPI Number: | 1922417674 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CDE |
| License Number: | 21310468 |
| Business Practice Address: | 105365 South Hwy 102 Mcloud, OK - 74851 |
| Business Phone Number: | 4059642081 |
| Business Fax Number: | 4059642170 |
| Mailing Address: | 2011 Saddleback Blvd, NORMAN |
| State: | OK |
| Postal Code: | 730722806 |
| Phone Number: | 4055936571 |
| Fax Number: | 4059642170 |
| NPI Enumeration Date: | 08/07/2014 |
| NPI Last Update Date: | 08/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | 21310468 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |