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NPI Code Detail

MEDICARE: STACIE MARIE CORTRIGHT APRN, CPNP-PC

MEDICARE: STACIE MARIE CORTRIGHT APRN, CPNP-PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner201208OK

General Provider Information

NPI Number : 1598350779
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACIE MARIE CORTRIGHT APRN, CPNP-PC
Provider Business Mailing Address
First Line : 4402 WHISPERING CREEK DR
Second Line :
City : SAND SPRINGS
State : OK
Zip : 74063-3175
Country : US
Telephone Number : 918-851-5153
Fax Number :
Provider Business Practice Location Address
First Line : 5323 S. 65TH WEST AVENUE
Second Line :
City : TULSA
State : OK
Zip : 74107
Country : US
Telephone Number : 918-340-5024
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2021
Last Update Date : 03/09/2021

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