Provider Demographics
NPI:1003414673
Name:STEPHENS, STEPHANIE ANN (PA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 PARKWAY COMMONS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6104
Mailing Address - Country:US
Mailing Address - Phone:405-249-1936
Mailing Address - Fax:
Practice Address - Street 1:14100 PARKWAY COMMONS DR STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-6104
Practice Address - Country:US
Practice Address - Phone:405-749-2765
Practice Address - Fax:405-749-6209
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant