Healthcare Provider Details

I. General information

NPI: 1609701960
Provider Name (Legal Business Name): STONEROCK FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22280 EW 26 RD
CHELSEA OK
74016-1685
US

IV. Provider business mailing address

22280 EW 26 RD
CHELSEA OK
74016-1685
US

V. Phone/Fax

Practice location:
  • Phone: 580-304-6298
  • Fax:
Mailing address:
  • Phone: 580-304-6298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: NICKI CARRIERE
Title or Position: FAMILY NURSE PRACTIONER/OWNER
Credential: NP
Phone: 580-304-6298