Provider Demographics
NPI:1841848975
Name:TINSLEY, CHRISTINA DAWN
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:DAWN
Last Name:TINSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-6310
Mailing Address - Country:US
Mailing Address - Phone:918-710-4260
Mailing Address - Fax:918-403-6331
Practice Address - Street 1:1200 S BELMONT AVE
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6310
Practice Address - Country:US
Practice Address - Phone:918-710-4260
Practice Address - Fax:918-403-6331
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-02
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0095897363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily