Healthcare Provider Details

I. General information

NPI: 1821967183
Provider Name (Legal Business Name): STEPHANIE MCDAVID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 NW 116TH ST
OKLAHOMA CITY OK
73114-7321
US

IV. Provider business mailing address

408 NW 116TH ST
OKLAHOMA CITY OK
73114-7321
US

V. Phone/Fax

Practice location:
  • Phone: 405-473-3657
  • Fax:
Mailing address:
  • Phone: 405-473-3657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: