Stacy Danielle Provence
Pediatric Nurse Practitioner · Bethany, OK
Practice location
6800 NW 39TH ExpyBethany, OK 73008-2513
- Phone
- (405) 789-6711
- Fax
- (405) 440-6716
NPI record
- NPI
- 1912376765
- Entity type
- Individual (Type 1)
- Enumeration date
- September 23, 2015
- Last updated
- November 14, 2019
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X |
0089753 | OK |
About Stacy Provence
Stacy Danielle Provence is a healthcare provider registered in the NPI registry with the primary taxonomy Pediatric Nurse Practitioner (code 363LP0200X). The practice location is 6800 NW 39TH Expy, Bethany, OK 73008-2513. The NPI number 1912376765 was assigned on September 23, 2015 and the record was last updated on November 14, 2019.
Stacy Provence lists a license in the registry: #0089753 (OK) for Pediatric Nurse Practitioner. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Stacy Danielle Provence?
The NPI number is 1912376765.
What is the phone number of Stacy Provence?
The phone number listed for the practice location is (405) 789-6711.
Where is Stacy Provence located?
6800 NW 39TH Expy, Bethany, OK 73008-2513.
What is the taxonomy code for Stacy Provence?
The primary taxonomy code is 363LP0200X – Pediatric Nurse Practitioner.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
Other Pediatric Nurse Practitioner providers in Bethany
- David Mathew, APRN6800 NW 39TH Expy
- Ebony C. Fortier, MSN APRN FNP-C6800 NW 39TH Expy