Russell, Stephanie
Russell, Stephanie is an individual health care provider with primary practice located at 8115 S Memorial Dr , Tulsa OK 74133-4331. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Russell, Stephanie can be contacted via phone (918) 254-6315.Contact Information
Primary practice address
8115 S Memorial Dr
Tulsa OK 74133-4331
Phone: (918) 254-6315
Fax: (918) 403-6315
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 932 | Oklahoma |
Profile Details
| NPI number | 1235199118 |
|---|---|
| LBN Legal business name | Russell, Stephanie |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | May 6th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235199118 | NPPES |
| Oklahoma | MEDICAID | 100740390A |
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