Healthcare Provider Details

I. General information

NPI: 1235787672
Provider Name (Legal Business Name): MISTY STEPHENS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2019
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7912 E 31ST CT STE 200
TULSA OK
74145-1334
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 200
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-8200
  • Fax:
Mailing address:
  • Phone: 727-322-3439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR010247
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: