DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

STACY DANIELLE PROVENCE

Active

STACY DANIELLE PROVENCE is a Pediatric Nurse Practitioner healthcare provider located in BETHANY, Oklahoma. NPI 1912376765 is currently active in the NPPES registry. Verify at CMS.

Pediatric Nurse Practitioner · BETHANY, OK

Registration Details

NPI Number
1912376765
Provider Type
Individual
Gender
Female
NPI Issued
Sep 23, 2015 (10.864682406152 yrs)
Last Updated
Nov 14, 2019
License
0089753 (OK)

Practice Information

Address
6800 NW 39TH EXPY
BETHANY, OK, 730082513
Browse OK providers · Browse ZIP 73008
Phone
4057896711
Fax
4054406716
Primary Specialty
Pediatric Nurse Practitioner
363LP0200X

Other Pediatric Nurse Practitioner Providers in BETHANY, OK

Name Credential NPI
EBONY C COLEMAN MSN APRN FNP-C 1942717665
MR. DAVID MATHEW APRN 1861026254
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.