Provider Demographics
NPI:1205346814
Name:PINKSTON, ANGELA GAYLE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:GAYLE
Last Name:PINKSTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NW EXPWY ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-1802
Mailing Address - Country:US
Mailing Address - Phone:405-246-0811
Mailing Address - Fax:
Practice Address - Street 1:1900 NW EXPWY ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-1802
Practice Address - Country:US
Practice Address - Phone:405-246-0811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK84740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily