Provider Demographics
NPI:1407638513
Name:ORSINI, STEPHANE LYNN
Entity Type:Individual
Prefix:
First Name:STEPHANE
Middle Name:LYNN
Last Name:ORSINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STEPHANE
Other - Middle Name:LYNN
Other - Last Name:JUDD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7608 E 134TH PL S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3151
Mailing Address - Country:US
Mailing Address - Phone:918-820-2689
Mailing Address - Fax:
Practice Address - Street 1:8801 S 101ST EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5716
Practice Address - Country:US
Practice Address - Phone:918-820-2689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0110363163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice