Individual
STACEY LYNN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
4200 W MEMORIAL RD, SUITE 708, OKLAHOMA CITY, OK 73120-9350
(405) 749-0210
(405) 292-5505
Mailing address
4200 W MEMORIAL RD, SUITE 708, OKLAHOMA CITY, OK 73120-9350
(405) 749-0210
(405) 292-5505
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0034330
OK
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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