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General NPI Number Information
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NPI Number | 1053270660
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Entity Type | Individual
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Provider Name | MIRIAM STEPHANIA IBEH
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Gender |
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 2339 S GARY PL
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City | TULSA
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State | OK
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Zip | 74114-1806
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Country | US
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Telephone | 224-402-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 2339 S GARY PL
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City | TULSA
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State | OK
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Zip | 74114-1806
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Country | US
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Telephone | 224-402-5291
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R0123137
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License Number State | OK
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