Organization
WILBURTON FAMILY MEDICAL STEPHENIE INGRAM APRN CNP PLLC
Active
Other names
Wilburton Family Medical
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY BREWSTER (OFFICE MANAGER)
(918) 465-9612
Entity
Organization
Contact information
Practice address
210 W MAIN ST, WILBURTON, OK 74578-4046
(918) 465-9612
(918) 465-9613
Mailing address
210 W MAIN ST, WILBURTON, OK 74578-4046
(918) 465-9612
(918) 465-9613
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
72256
OK
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200426120A
—
OK
Enumeration date
10/31/2017
Last updated
07/17/2025
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