Provider Demographics
NPI:1982654752
Name:STEVENS, KRISTIN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MARIE
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:6465 S YALE AVE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7822
Mailing Address - Country:US
Mailing Address - Phone:918-481-4750
Mailing Address - Fax:918-481-4755
Practice Address - Street 1:6465 S YALE AVE
Practice Address - Street 2:SUITE 715
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7822
Practice Address - Country:US
Practice Address - Phone:918-481-4750
Practice Address - Fax:918-481-4755
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK22401208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics