IndividualActive
Brenda Stacy
NPI 1356889745 · Prevention Professional · Potesu, OK
Provider details
- NPI number
- 1356889745
- Entity type
- Individual
- Primary specialty
- Prevention ProfessionalOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 261QM0801X (OK)
Specialties & taxonomies
Other Service Providers
Practice location
507 Drwey
Potesu, OK 74953
Phone: (918) 649-0172
Approximate (ZIP-level) locationGet directions
Mailing address
507 Drwey
Potesu, OK 74953
Registry dates
- Enumerated
- 2017-02-06
- Last updated
- 2017-02-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.