Provider Demographics
NPI:1043199441
Name:STOCKER, WENDY GAIL
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:GAIL
Last Name:STOCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 NW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-2305
Mailing Address - Country:US
Mailing Address - Phone:918-348-2124
Mailing Address - Fax:
Practice Address - Street 1:509 NW 9TH ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-2305
Practice Address - Country:US
Practice Address - Phone:918-348-2124
Practice Address - Fax:918-348-2124
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKINJ-521342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company