Healthcare Provider Details

I. General information

NPI: 1619895836
Provider Name (Legal Business Name): STEPHANIE MARIE MCLEMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE MARIE LOVETT

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 PARKLAWN DR
MIDWEST CITY OK
73110-4201
US

IV. Provider business mailing address

2825 PARKLAWN DR
MIDWEST CITY OK
73110-4201
US

V. Phone/Fax

Practice location:
  • Phone: 405-610-1530
  • Fax:
Mailing address:
  • Phone: 405-610-1630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number230117
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: