Provider Demographics
NPI:1396495305
Name:STUBBS, AUBREY RENEE
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:RENEE
Last Name:STUBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-3614
Mailing Address - Country:US
Mailing Address - Phone:405-999-3284
Mailing Address - Fax:
Practice Address - Street 1:309 S MAIN ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3614
Practice Address - Country:US
Practice Address - Phone:405-999-3284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist