Provider Demographics
NPI:1487979688
Name:WHITE, STEPHANIE KAY
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:KAY
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:BYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1123 N MAIN ST
Mailing Address - Street 2:#7
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74106-4650
Mailing Address - Country:US
Mailing Address - Phone:918-640-0061
Mailing Address - Fax:
Practice Address - Street 1:2725 E SKELLY DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6241
Practice Address - Country:US
Practice Address - Phone:918-592-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-30
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management