Provider Demographics
NPI:1538344122
Name:STINSON, TINA M (PA)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:STINSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 WALL ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6302
Mailing Address - Country:US
Mailing Address - Phone:405-321-5114
Mailing Address - Fax:405-321-6482
Practice Address - Street 1:808 WALL ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6302
Practice Address - Country:US
Practice Address - Phone:405-321-5114
Practice Address - Fax:405-321-6482
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK637363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical