Individual
REBECCA JOY STAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
12716 NE 36TH ST, SPENCER, OK 73084-9167
(405) 769-3301
(405) 769-9685
Mailing address
PO BOX 30589, MIDWEST CITY, OK 73140-3589
(405) 769-3301
(405) 769-9685
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
R104170
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R104170
NURSING LICENSE
OK
Enumeration date
01/04/2012
Last updated
11/16/2012
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