Individual
JAQUETTA JARAE STEVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
109 NE 40TH ST, OKLAHOMA CITY, OK 73105-2415
(405) 785-4996
(833) 973-5942
Mailing address
1105 MICHELIN RD, ARDMORE, OK 73401-1085
(580) 224-8750
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
110221
OK
Other
Enumeration date
10/14/2019
Last updated
12/15/2025
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