Organization Active NPI

OB-GYN of Green Country

  • Women's Health Nurse Practitioner
  • Pryor, OK
National Provider Identifier
1720039415
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
R0071260 Issued in OK
Legal business name
OB-GYN OF GREEN COUNTRY
Practice address
14 S Vann St
Pryor, OK 74361-3613
Phone
(918) 825-4800
Fax
(918) 825-4809
NPI assigned
May 15, 2006
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tana M Stutzman, NPNPI 1902882269
Title
VP
Phone
(918) 825-4800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R0071260 OK Primary

Addresses

Primary practice location

14 S Vann St
Pryor, OK 74361-3613

Mailing address

14 S Vann St
Pryor, OK 74361-3613
Phone (918) 825-4800

National Provider Directory

National Provider Directory

Locations

2017 S Elm Pl
Ste 105
Broken Arrow, OK 74012
Phone (918) 449-1532

14 S Vann St
Pryor, OK 74361
Phone (918) 449-1532

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1720039415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S VANN ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743613613",
            "telephone_number": "918-825-4800",
            "fax_number": "918-825-4809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 S VANN ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743613613",
            "telephone_number": "918-825-4800",
            "fax_number": "918-825-4809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OB-GYN OF GREEN COUNTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "STUTZMAN",
        "authorized_official_first_name": "TANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "918-825-4800",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OK",
            "license": "R0071260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.