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GILLETTE, STEPHANIE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 209 PINE TREE DRIVE
BIGFORK MN 56628

Address last updated on 1/5/2016
Phone #: (580) 374-1311
Fax #:
County: NOT OKLAHOMA
License: 25389
Dated: 2/14/2007
Expires: 2/1/2018
License Type: Medical Doctor
Specialty: Family Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of KS Sch Of Med, Kansas City Ks 66103
Graduated: 6 / 1984
CME Year: 2019
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF FAMILY MEDICINE
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Great Plains Regional Medical Center
Elk City, OK
Hospital Not Listed
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Hospital(s) Not In Oklahoma
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Locations: Hours: Languages:
209 PINE TREE DRIVE
BIGFORK MN 56628

Phone #: (580) 374-1311
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun: FULL TIME LOCUM TENENS

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