Stacey, Kendra K
Stacey, Kendra K is an individual health care provider with primary practice located at 102 Nw 31St , Lawton OK 73505. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Stacey, Kendra K can be contacted via phone (580) 353-6790.Contact Information
Primary practice address
102 Nw 31St
Lawton OK 73505
Phone: (580) 353-6790
Fax: (580) 510-7019
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R0052337 | Oklahoma |
Physician Assistants & Advanced Practice Nursing Providers / Obstetrics & Gynecology | 363LX0001X | R0052337 | Oklahoma |
Profile Details
NPI number | 1124014790 |
---|---|
LBN Legal business name | Stacey, Kendra K |
Credentials | ARNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 20th, 2005 |
Last updated | Feb 12th, 2008 - about 17 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 | 1124014790 | NPPES |
Oklahoma | Other | 7591256 | AETNA |
Oklahoma | Other | 628427054001 | AETNA |
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