Individual
MRS. MANDA LEA STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
205 S PARK LN, ALTUS, OK 73521-5755
(580) 379-6710
(580) 379-6714
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5000
(580) 379-5509
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
66290
OK
363LA2200X
Adult Health Nurse Practitioner
Primary
66290
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200388530A
—
OK
Enumeration date
09/13/2011
Last updated
10/30/2025
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