Individual
STEPHANIE ANN DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
119 W MAIN ST, HOMINY, OK 74035-1031
(918) 885-4640
(918) 885-4644
Mailing address
212 N MAIN ST, FAIRFAX, OK 74637-3023
(918) 642-3100
(918) 642-5639
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
64988
OK
363LA2200X
Adult Health Nurse Practitioner
AG08170142
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R0064988
OK
Other
Enumeration date
10/05/2017
Last updated
04/08/2026
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