Individual
DR. NICOLE MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8422 N 123RD EAST AVE, OWASSO, OK 74055-2130
(918) 858-4353
Mailing address
8418 N 123RD EAST AVE, OWASSO, OK 74055-2139
(918) 858-4353
(866) 246-2942
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2942
OK
363A00000X
Physician Assistant
085002618
IL
363A00000X
Physician Assistant
2942
OK
363AM0700X
Medical Physician Assistant
Primary
2942
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528173028
—
OK
Enumeration date
08/21/2006
Last updated
03/06/2026
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