Provider Demographics
NPI:1427634500
Name:STADLER, JESSICA KAY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:KAY
Last Name:STADLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 S WHEELING AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5635
Mailing Address - Country:US
Mailing Address - Phone:918-634-7500
Mailing Address - Fax:
Practice Address - Street 1:1919 S WHEELING AVE STE 600
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5635
Practice Address - Country:US
Practice Address - Phone:918-634-7500
Practice Address - Fax:918-634-7560
Is Sole Proprietor?:No
Enumeration Date:2021-03-20
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201643363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner