Healthcare Provider Details
I. General information
NPI: 1598284358
Provider Name (Legal Business Name): STEPHANIE SUE MCQUARTERS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/13/2017
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1239 S TRENTON AVE
TULSA OK
74120-5420
US
IV. Provider business mailing address
1239 S TRENTON AVE
TULSA OK
74120-5420
US
V. Phone/Fax
- Phone: 918-582-2131
- Fax: 918-588-8803
- Phone: 918-582-2131
- Fax: 918-588-8803
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | R72210 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R72210 |
| License Number State | OK |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LA2100X |
| Taxonomy | Acute Care Nurse Practitioner |
| License Number | R72210 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: