Provider Demographics
NPI:1740545722
Name:STEVENS, TIMMENI LYNN (DO)
Entity type:Individual
Prefix:DR
First Name:TIMMENI
Middle Name:LYNN
Last Name:STEVENS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TIMMENI
Other - Middle Name:LYNN
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:701 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-4316
Mailing Address - Country:US
Mailing Address - Phone:918-298-2603
Mailing Address - Fax:
Practice Address - Street 1:8803 S 101ST EAST AVE STE 245
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5730
Practice Address - Country:US
Practice Address - Phone:918-858-0008
Practice Address - Fax:918-858-0074
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5380207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology