Provider Demographics
NPI:1063126837
Name:MILLER, STEPHANIE DENISE
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:DENISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 S ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4220
Mailing Address - Country:US
Mailing Address - Phone:405-269-9879
Mailing Address - Fax:
Practice Address - Street 1:719 S ORCHARD ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4220
Practice Address - Country:US
Practice Address - Phone:405-269-9879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-06
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator