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Individual

MICHELLE RAE STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
900 E MAIN ST BLDG 52, NORMAN, OK 73071-5305
(405) 307-4800
Mailing address
505 W COMANCHE ST # A, NORMAN, OK 73069-5616
(580) 736-1372

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
64158
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
64158
OKLAHOMA BOARD OF NURSING
OK
Enumeration date
07/04/2017
Last updated
07/04/2017
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