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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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EDENBOROUGH, BREANNA ROCHELLE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 4651 N HARRISION ST.
SHAWNEE OK 74820

Address last updated on 11/6/2024
Phone #:
Fax #:
County: POTTAWATOMIE
License: 5327
Dated: 7/27/2017
Expires: 1/31/2025
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
4651 N HARRISION ST.
SHAWNEE OK 74820

Phone #:
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TYLER C BARTON TA 3179
JAMIE ANN FESLER TA 2387
LYNETTE NICHELLE HOUSTON TA 2041
APRIL LYN METCALF TA 737
SHYANNA DAWN SMITH TA 3485
MEGAN KRISTINE WILKEY TA 2899

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