Individual
KELLY STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1402 N FLORENCE AVE STE B, CLAREMORE, OK 74017-3159
(918) 608-0380
Mailing address
PO BOX 521147, TULSA, OK 74152-1147
(918) 608-0380
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R0060065
OK
Other
Enumeration date
09/28/2016
Last updated
03/06/2021
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