Individual
LYNNETTA FAYE STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
718 AVENUE A, BEAVER, OK 73932-3101
(580) 625-3477
(580) 625-3562
Mailing address
PO BOX 640, BEAVER, OK 73932-0640
(580) 625-3477
(580) 625-3562
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
46285
KS
363LF0000X
Family Nurse Practitioner
Primary
R0094046
OK
Other
Enumeration date
10/03/2008
Last updated
07/17/2014
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