Provider Demographics
NPI:1588263495
Name:BREWER, CANDYSE ELIZABETH (APRN-CNS)
Entity type:Individual
Prefix:
First Name:CANDYSE
Middle Name:ELIZABETH
Last Name:BREWER
Suffix:
Gender:F
Credentials:APRN-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 HEALTHPLEX PKWY
Mailing Address - Street 2:# 200
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-9738
Mailing Address - Country:US
Mailing Address - Phone:405-429-0530
Mailing Address - Fax:
Practice Address - Street 1:3500 HEALTHPLEX PKWY STE 200
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-9738
Practice Address - Country:US
Practice Address - Phone:405-515-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0113218364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology