Individual
KAMIE NICHOLE STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 W BROADWAY ST, MUSKOGEE, OK 74401-2763
(918) 463-2581
(918) 463-2585
Mailing address
PO BOX 1267, MUSKOGEE, OK 74402-1267
(918) 463-2581
(918) 463-2585
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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