Provider Demographics
NPI:1942781927
Name:STONE, SAMMIE LYNN (APRN, CNP, AGPCNP)
Entity Type:Individual
Prefix:
First Name:SAMMIE
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:APRN, CNP, AGPCNP
Other - Prefix:
Other - First Name:SAMMIE
Other - Middle Name:LYNN
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, CNP, AGPCNP
Mailing Address - Street 1:414 CRABTREE LANE
Mailing Address - Street 2:
Mailing Address - City:KIOWA
Mailing Address - State:OK
Mailing Address - Zip Code:74553
Mailing Address - Country:US
Mailing Address - Phone:918-424-3459
Mailing Address - Fax:
Practice Address - Street 1:4 E CLARK BASS BLVD STE 301
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4269
Practice Address - Country:US
Practice Address - Phone:918-426-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0078413363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care