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Contact Information

BRIAN T PENDARVIS, ARNP
205 SOUTH MAIN STREET
NOBLE, OK73068
 Phone: 405-872-5403
 Fax: 405-872-5407
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BRIAN T PENDARVIS · (Male)

NPI # 1417952904
Status Active
Credentials ARNP (Advanced Registered Nurse Practitioner)
Entity Individual
Enumeration date 06/20/2005
Last updated 01/30/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • OK License # R0067224
  • OK Medicaid 200043980A
Hospital affiliation(s)
  • NORMAN REGIONAL HEALTH SYSTEM - (Acute Care)
    901 NORTH PORTER
    NORMAN, OK 73070
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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