Individual
KELLEY REBEKAH STUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN-CNP, FNP-C
Contact information
Practice address
4705 S 129TH EAST AVE, TULSA, OK 74134-7005
(833) 863-3947
Mailing address
4705 S 129TH EAST AVE, TULSA, OK 74134-7005
(918) 994-3471
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
113764
OK
363LF0000X
Family Nurse Practitioner
Primary
204582
OK
Other
Enumeration date
04/08/2021
Last updated
09/19/2021
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