Individual
ANNALOU STASILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
832 ISABEL ST, ARDMORE, OK 73401-5118
(405) 986-9245
Mailing address
15520 ALLEGHENY DR, EDMOND, OK 73013-8826
(405) 520-5749
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
99396
OK
364SL0600X
Long-Term Care Clinical Nurse Specialist
Primary
218602
OK
Other
Enumeration date
03/11/2024
Last updated
08/05/2024
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