Provider Demographics
NPI:1316214430
Name:HOUSTON, TONYA L (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:L
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:L
Other - Last Name:KINAID-COTTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 S VINE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OK
Mailing Address - Zip Code:74020
Mailing Address - Country:US
Mailing Address - Phone:256-770-5420
Mailing Address - Fax:918-579-5404
Practice Address - Street 1:PAWNEE INDIAN HEALTH CENTER
Practice Address - Street 2:1201 HERITAGE CIR
Practice Address - City:PAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74058
Practice Address - Country:US
Practice Address - Phone:918-762-6539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR63708363LF0000X, 363LN0000X
AL1-165361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal