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General NPI Number Information
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NPI Number | 1457820870
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Entity Type | Individual
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Provider Name | STEPHANIE DAWN ANDERSON APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 07/28/2024
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Provider Practice Location Address
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Address Line | 12220 N MACARTHUR BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-1850
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Country | US
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Telephone | 405-437-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 11810 S COUNCIL RD
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City | CASHION
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State | OK
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Zip | 73016-9627
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Country | US
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Telephone | 140-548-8423
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 99387
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License Number State | OK
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