Provider Demographics
NPI:1497227078
Name:OLIVER, STEPHANIE ZEIDERS (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ZEIDERS
Last Name:OLIVER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ZEIDERS
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5339
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73403-0339
Mailing Address - Country:US
Mailing Address - Phone:580-223-7472
Mailing Address - Fax:580-223-6673
Practice Address - Street 1:1115 WALNUT DR
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2354
Practice Address - Country:US
Practice Address - Phone:580-223-7472
Practice Address - Fax:580-223-6673
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK66897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily