Provider Demographics
NPI:1366831455
Name:PORTER, STEPHANIE (PA)
Entity Type:Individual
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First Name:STEPHANIE
Middle Name:
Last Name:PORTER
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Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1330
Mailing Address - Country:US
Mailing Address - Phone:405-307-6668
Mailing Address - Fax:405-701-6170
Practice Address - Street 1:500 E ROBINSON ST
Practice Address - Street 2:SUITE 2300
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6697
Practice Address - Country:US
Practice Address - Phone:405-329-4102
Practice Address - Fax:405-307-5625
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2016-02-22
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant