WILBURTON FAMILY MEDICAL STEPHENIE INGRAM APRN CNP PLLC NPI 1538671425

NPI Information

NPI: 1538671425
Provider Name: WILBURTON FAMILY MEDICAL STEPHENIE INGRAM APRN CNP PLLC

Other Name: WILBURTON FAMILY MEDICAL

Classification: Registered Nurse - 163WG0000X
Entity Type: Organization

Specialization: General Practice

Address:
210 W MAIN ST
WILBURTON, OK
ZIP 74578
Phone: (918) 465-9612
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WILBURTON FAMILY MEDICAL STEPHENIE INGRAM APRN CNP PLLC is a general practice registered nurse in Wilburton, OK. WILBURTON FAMILY MEDICAL STEPHENIE INGRAM APRN CNP PLLC NPI is 1538671425. The provider is registered as an organization entity type.
The provider Other Name Is Wilburton Family Medical.

The provider's business location address is:

210 W MAIN ST
WILBURTON, OK
ZIP 74578-046
Phone: (918) 465-9612
Fax: (918) 465-9613

The provider's authorized official is Judy Brewster .
The authorized official title is Office Manager and has the following contact phone number (918) 465-9612.

The enumeration date for this NPI number is 10/31/2017 and was last updated on 6/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			No
2	261Q00000X	Clinic/Center				No
3	163WG0000X	Registered Nurse	General Practice	72256	OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200426120A	MEDICAID	OKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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