Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy Danielle Provence

Individual provider Pediatric Nurse Practitioner · NPI 1912376765

Stacy Danielle Provence is a Pediatric Nurse Practitioner in Bethany, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2015.

Licensed in
OK
In the registry since
2015

Practice location Address checks out

6800 NW 39th Expy
Bethany, OK 73008-2513
Phone: (405) 789-6711
Fax: (405) 440-6716
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Nurse Practitioner (primary) Taxonomy 363LP0200X · Licence 0089753 (OK)

Record details

NPI number1912376765
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 23, 2015
Last updated in NPPESNovember 14, 2019
Mailing address6800 Nw 39th Expy, Bethany, OK 73008-2513

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