Individual
TINA STULTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN ADMINISTRATOR
Contact information
Practice address
1510 W MAIN ST, DUNCAN, OK 73533-4333
(580) 560-1879
(580) 255-3933
Mailing address
1510 W MAIN ST, DUNCAN, OK 73533-4333
(580) 255-3926
(580) 255-3933
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
R0089788
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200265030A
—
OK
Enumeration date
03/16/2022
Last updated
04/29/2022
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