Individual
STACEY R MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN FNP-BC
Contact information
Practice address
550 W 125TH PL S STE 200, GLENPOOL, OK 74033-5026
(918) 224-7305
Mailing address
550 W 125TH PL S STE 200, GLENPOOL, OK 74033-5026
(918) 224-7305
(918) 224-7291
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
201354
OK
Other
Enumeration date
02/18/2021
Last updated
12/28/2022
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