Provider Demographics
NPI:1316836901
Name:GILDON, TASHANNA (RN)
Entity type:Individual
Prefix:
First Name:TASHANNA
Middle Name:
Last Name:GILDON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 S SAINT PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-4515
Mailing Address - Country:US
Mailing Address - Phone:405-210-6930
Mailing Address - Fax:
Practice Address - Street 1:713 S SAINT PAUL AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-4515
Practice Address - Country:US
Practice Address - Phone:405-210-6930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0087334163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse