Individual
MRS. STACY LYNN BOOTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
3500 HEALTHPLEX PKWY, SUITE 200, NORMAN, OK 73072-9738
(405) 515-2222
(405) 515-2251
Mailing address
PO BOX 1330, NORMAN, OK 73070-1330
(405) 515-2222
(405) 307-6660
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R0072509
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200091170
—
OK
05
—
200091170A
—
OK
Enumeration date
06/01/2006
Last updated
04/11/2014
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