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NPI 1982026456

NPI 1982026456 : REBECCA STEPHEN PA : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1982026456
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    Entity Type          |    Individual 
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    Provider Name        |    REBECCA STEPHEN PA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/17/2014
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    Last Update Date     |    01/29/2025
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Provider Practice Location Address
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    Address Line         |    717 S HOUSTON AVE STE 400 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74127-9007
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    Country              |    US
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    Telephone            |    918-582-7711
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    Fax                  |    918-583-5831
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Provider Business Mailing Address
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    Address Line         |    5310 E 31ST ST STE 13 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74135-5013
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    Country              |    US
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    Telephone            |    918-561-5701
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    Fax                  |    918-561-1173
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    2367
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    License Number State |    OK
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