Individual
KEISHA LYNNELL STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
1258 E 145TH PL S, GLENPOOL, OK 74033-4014
(918) 497-0357
Mailing address
PO BOX 481083, TULSA, OK 74148-1083
(918) 497-0357
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0054917
OK
Other
Enumeration date
03/12/2015
Last updated
03/12/2015
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