Individual
STEPHANIE ARLENE WHATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2821 N VAN BUREN ST STE B, ENID, OK 73703-1729
(580) 213-9794
(580) 213-9795
Mailing address
5300 N INDEPENDENCE AVE, OKLAHOMA CITY, OK 73112-5556
(580) 213-9794
(580) 213-9795
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1136
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200004000A
—
OK
01
—
P01318927
RR MEDICARE
OK
Enumeration date
04/06/2006
Last updated
02/12/2018
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