NPI 1356889745

Brenda Stacy

Practitioner Prevention Professional Potesu, OK

Practice location

Address: 507 Drwey, Potesu, OK 74953
Phone: (918) 649-0172

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 261QM0801X (OK)

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Registry record

NPI: 1356889745
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Feb 2017
Record last updated: 6 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.