Stacy Danielle Provence, - Nurse Practitioner in Bethany, OK

Stacy Danielle Provence, is a Nurse Practitioner - Pediatrics based in Bethany, Oklahoma. Stacy Danielle Provence is licensed to practice in Oklahoma (license number 0089753) and her current practice location is 6800 Nw 39th Expy, Bethany, Oklahoma. She can be reached at her office (for appointments etc.) via phone at (405) 789-6711.

NPI number for Stacy Danielle Provence is 1912376765 and her current mailing address is 6800 Nw 39th Expy, Bethany, Oklahoma. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1912376765.

Contact Information

Stacy Danielle Provence,
6800 Nw 39th Expy,
Bethany, OK 73008-2513
(405) 789-6711
(405) 440-6716



Provider's Profile

Full NameStacy Danielle Provence
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location6800 Nw 39th Expy, Bethany, Oklahoma
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1912376765
  • Provider Enumeration Date: 09/23/2015
  • Last Update Date: 11/14/2019

Medical Identifiers

Medical identifiers for Stacy Danielle Provence such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1912376765NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 0089753 (Oklahoma)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stacy Danielle Provence is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Stacy Danielle Provence,
6800 Nw 39th Expy,
Bethany, OK 73008-2513

Ph: (405) 789-6711
Stacy Danielle Provence,
6800 Nw 39th Expy,
Bethany, OK 73008-2513

Ph: (405) 789-6711

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› Verified 9 days ago


Nurse Practitioner Nurses in Bethany, OK

Jessica Wynn Harris, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008
Phone: 405-789-6711    Fax: 405-440-6750
Tami Mcmichael, NURSE PRACTITIONER
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008
Phone: 405-789-6711    Fax: 405-789-5978
Braden Peterson, APRN-BC
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6814 Nw 23rd St, Bethany, OK 73008
Phone: 405-603-1175    
Ms. Lyn Glezen Brant, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6801 Nw 39th Expy, Bethany, OK 73008
Phone: 405-789-2441    Fax: 405-789-7978
Adele Burt, APRN
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008
Phone: 405-440-9866    
Jason C Klein, CPNP, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 6800 Nw 39th Expy, Bethany, OK 73008
Phone: 405-789-6711    Fax: 405-438-3834
Yvonne R Chambers, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 7600 Nw 23rd St, Bethany, OK 73008
Phone: 405-792-5330    

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