Healthcare Provider Details

I. General information

NPI: 1760780118
Provider Name (Legal Business Name): ANDREA R PRICE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA STOBBE

II. Dates (important events)

Enumeration Date: 03/09/2011
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date: 07/21/2025
Reactivation Date: 09/03/2026

III. Provider practice location address

7050 AIR DEPOT BLVD STE 1094
TINKER AFB OK
73145-8716
US

IV. Provider business mailing address

7050 AIR DEPOT BLVD STE 1094
TINKER AFB OK
73145-8716
US

V. Phone/Fax

Practice location:
  • Phone: 405-734-2778
  • Fax:
Mailing address:
  • Phone: 405-734-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN1000866NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: