Individual
STEPHANIE NICOLE O'HALLORAN-WILKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1675 E SEMINOLE ST, SPRINGFIELD, MO 65804-2490
(417) 557-2355
(417) 530-1455
Mailing address
117 S. LEXINGTON ST., SUITE 100, SPRINGFIELD, MO 65804-2490
(816) 865-6400
(314) 464-0387
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2022008045
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2022008045
STATE LICENSE
MO
Enumeration date
04/20/2022
Last updated
04/03/2026
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