STULL, MANDY MARIE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

STULL, MANDY MARIE

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:	IGNITE MEDICAL RESOURTS NORMAN 1050 RAMBLING OAKS DRIVE NORMAN OK 73072 Address last updated on 3/6/2024
Phone #:	(405) 292-2273
Fax #:
County:	CLEVELAND
License:	1047
Dated:	7/5/2001
Expires:	1/31/2025
Temp. Ltr. Issued:	5/31/2001
Temp. Ltr. Expires:	9/21/2001
License Type:	Physical Therapist Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2026

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:
IGNITE MEDICAL RESOURTS NORMAN 1050 RAMBLING OAKS DRIVE NORMAN OK 73072 Phone #: (405) 292-2273 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
ROBIN WALKER HEBBLETHWAITE	PT	3630

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