Individual
MS. STACY LYNN NEWBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNS
Contact information
Practice address
10109 E 79TH ST, TULSA, OK 74133-4564
(918) 286-5000
(918) 249-7514
Mailing address
10109 E 79TH ST, TULSA, OK 74133-4564
(918) 286-5000
(918) 249-7514
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0055982
OK
363LG0600X
Gerontology Nurse Practitioner
R0055982
OK
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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