Individual
TINA G WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
501 EAST SECOND STREET, HEAVENER, OK 74937
(918) 653-7718
(918) 653-7279
Mailing address
POST OFFICE BOX 846, 501 EAST SECOND STREET, HEAVENER, OK 74937
(918) 653-7718
(918) 653-7279
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R0042147
OK
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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