Boothe, Stacy Lynn

Boothe, Stacy Lynn is an individual health care provider with primary practice located at 3500 Healthplex Pkwy Suite 200, Norman OK 73072-9738. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, which is considered as her primary health care specialty. Boothe, Stacy Lynn can be contacted via phone (405) 515-2222.

Contact Information

Primary practice address
3500 Healthplex Pkwy Suite 200 Norman OK 73072-9738
Phone: (405) 515-2222
Fax: (405) 515-2251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X R0072509 Oklahoma

Profile Details

NPI number 1114964913
LBN Legal business name Boothe, Stacy Lynn
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2006
Last updated Apr 11th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114964913 NPPES
Oklahoma MEDICAID 200091170A
Oklahoma MEDICAID 200091170

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