| Stacy Danielle Provence, | |
|
6800 Nw 39th Expy, Bethany, OK 73008-2513 | |
| (405) 789-6711 | |
| (405) 440-6716 |
| Full Name | Stacy Danielle Provence |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Pediatrics |
| Location | 6800 Nw 39th Expy, Bethany, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912376765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 0089753 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Stacy Danielle Provence, 6800 Nw 39th Expy, Bethany, OK 73008-2513 Ph: (405) 789-6711 | Stacy Danielle Provence, 6800 Nw 39th Expy, Bethany, OK 73008-2513 Ph: (405) 789-6711 |
Jessica Wynn Harris, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008 Phone: 405-789-6711 Fax: 405-440-6750 | |
Bao Nguyen, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008 Phone: 405-789-6711 | |
Tami Mcmichael, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008 Phone: 405-789-6711 Fax: 405-789-5978 | |
Braden Peterson, APRN-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6814 Nw 23rd St, Bethany, OK 73008 Phone: 405-603-1175 | |
Ms. Lyn Glezen Brant, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6801 Nw 39th Expy, Bethany, OK 73008 Phone: 405-789-2441 Fax: 405-789-7978 | |
Adele Burt, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008 Phone: 405-440-9866 | |
Jason C Klein, CPNP, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008 Phone: 405-789-6711 Fax: 405-438-3834 |