Stephanie Michelle Anderson, BSN

Individual provider Active NPI Case Management Registered Nurse · Okmulgee, OK

NPI 1386492965 · NPPES record last updated May 9, 2024

Key facts

NPI
1386492965
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Registered Nurse 163WC0400X
License
R0113867 (OK)
Practice address
1401 Morris Dr
Okmulgee, OK 74447-6429
Phone
(918) 756-4233
NPI assigned
May 9, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
R0113867OKMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0113867 OK
Case Management Registered Nurse 163WC0400X R0113867 OK Yes

Addresses

Primary practice location

1401 Morris Dr
Okmulgee, OK 74447-6429

Mailing address

3230 N 17TH St W
Muskogee, OK 74401-2437
Phone (918) 710-8501

Other providers in Okmulgee, OK

All providers in Okmulgee, OK · Case Management Registered Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.