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Individual

MRS. PAMELA LOUISE STOUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, IBCLC

Contact information

Practice address
813 PRAIRIE VIEW RD., ARDMORE, OK 73401
(937) 657-4046
Mailing address
813 PRAIRIE VIEW RD., ARDMORE, OK 73401
(937) 657-4046

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0132312
OK
174N00000X
Lactation Consultant (Non-RN)
L-34582

Other

Enumeration date
02/16/2021
Last updated
02/16/2021
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