Individual
MRS. TINA DIANE GERWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1570 PROVENCE RD, ARDMORE, OK 73401-0401
(580) 220-4427
Mailing address
1570 PROVENCE RD, ARDMORE, OK 73401-0401
(580) 220-4427
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
216494
OK
Other
Enumeration date
02/21/2024
Last updated
02/21/2024
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