Provider Demographics
NPI:1154005551
Name:ELROD, STEVEN (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ELROD
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 E 2ND ST APT 5208
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-1809
Mailing Address - Country:US
Mailing Address - Phone:888-789-2256
Mailing Address - Fax:888-404-1909
Practice Address - Street 1:2133 E 2ND ST APT 5208
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-1809
Practice Address - Country:US
Practice Address - Phone:888-789-2256
Practice Address - Fax:888-404-1909
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-14
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK212047363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health