RUSSELL, STEPHANIE ANN - Licensee Information

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

RUSSELL, STEPHANIE ANN

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:	ST. JOHN CLINIC OUTPATIENT OFFICE 8115 S MEMORIAL DRIVE TULSA OK 74133 Address last updated on 2/22/2024
Phone #:	(918) 254-6315
Fax #:	(918) 403-6315
County:	TULSA
License:	932
Dated:	4/1/1999
Expires:	3/31/2025
Temp. Ltr. Issued:	12/17/1998
Temp. Ltr. Expires:	3/31/1999
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

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.

Locations:	Hours:	Languages:
ST. JOHN CLINIC OUTPATIENT OFFICE 8115 S MEMORIAL DRIVE TULSA OK 74133 Phone #: (918) 254-6315 Fax #: (918) 403-6315

Hospital Privileges:

None listed

Name:	Type:	License Number:
Primary Supervisor(s):
Adam Benjamin Greer	DO	5980
ETHEL VASQUEZ-HARMON	DO	3264
RITA S. WESTENHAVER	DO	2731

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