Individual
STACEY GAYLE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
317 N ROCKFORD RD, ARDMORE, OK 73401-2552
(580) 319-4242
Mailing address
4527 W BROADWAY ST, ARDMORE, OK 73401-9076
(580) 504-1988
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
206990
OK
Other
Enumeration date
04/11/2022
Last updated
04/11/2022
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