Provence, Stacy Danielle

Provence, Stacy Danielle is an individual health care provider with primary practice located at 6800 Nw 39Th Expy , Bethany OK 73008-2513. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Provence, Stacy Danielle can be contacted via phone (405) 789-6711.

Contact Information

Primary practice address
6800 Nw 39Th Expy Bethany OK 73008-2513
Phone: (405) 789-6711
Fax: (405) 440-6716
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 0089753 Oklahoma

Profile Details

NPI number 1912376765
LBN Legal business name Provence, Stacy Danielle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2015
Last updated Nov 14th, 2019 - about 6 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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