Provider Demographics
NPI:1275328601
Name:STEGEMAN, MAKENZIE RENEE
Entity type:Individual
Prefix:
First Name:MAKENZIE
Middle Name:RENEE
Last Name:STEGEMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4218 PATRICK HENRY PL
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1340
Mailing Address - Country:US
Mailing Address - Phone:580-478-8734
Mailing Address - Fax:
Practice Address - Street 1:409 E CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5814
Practice Address - Country:US
Practice Address - Phone:580-234-8865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker