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General NPI Number Information
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NPI Number | 1477746188
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Entity Type | Individual
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Provider Name | MS. STEPHANIE MARIE HELLER
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Gender | Female
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Dates
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Enumeration Date | 08/26/2007
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Last Update Date | 08/26/2007
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Provider Practice Location Address
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Address Line | 1125 S TRENTON AVE
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City | TULSA
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State | OK
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Zip | 74120-5418
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Country | US
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Telephone | 918-845-6097
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 W DETROIT ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-2160
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Country | US
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Telephone | 918-845-6097
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 972
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 282E00000X
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Taxonomy Name | Long Term Care Hospital
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License Number | 972
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License Number State | OK
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