Healthcare Provider Details

I. General information

NPI: 1912158957
Provider Name (Legal Business Name): CAROL FRANCES STEWART CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 N. SIOUX
CLAREMORE OK
74017-0000
US

IV. Provider business mailing address

2990 N. SIOUX
CLAREMORE OK
74017-0000
US

V. Phone/Fax

Practice location:
  • Phone: 918-342-2622
  • Fax:
Mailing address:
  • Phone: 918-342-2622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberROO37408
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: