Basic Information
Provider Information | |||||||||
NPI: | 1073749107 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | STEPHENS | ||||||||
FirstName: | KIERA | ||||||||
MiddleName: | MARIE | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | AU.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | CYPHERS | ||||||||
OtherFirstName: | KIERA | ||||||||
OtherMiddleName: | MARIE | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 825 N.E. 10TH ST | ||||||||
Address2: | SUITE 4200 | ||||||||
City: | OKLAHOMA CITY | ||||||||
State: | OK | ||||||||
PostalCode: | 73104 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4052717559 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 825 N.E. 10TH ST | ||||||||
Address2: | SUITE 4200 | ||||||||
City: | OKLAHOMA CITY | ||||||||
State: | OK | ||||||||
PostalCode: | 73104 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4052717559 | ||||||||
FaxNumber: | 4052717654 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/03/2009 | ||||||||
LastUpdateDate: | 06/03/2009 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 371 | OK | Y |   | Speech, Language and Hearing Service Providers | Audiologist |   |
No ID Information.