Provider Demographics
NPI:1750085064
Name:STEPHENS, SABRINA ANN (PMHNP)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:ANN
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-2016
Mailing Address - Country:US
Mailing Address - Phone:580-772-1623
Mailing Address - Fax:580-203-3463
Practice Address - Street 1:1322 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2016
Practice Address - Country:US
Practice Address - Phone:580-772-1623
Practice Address - Fax:580-203-3463
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK205341364SP0808X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty