Individual
TABITHA JEAN PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP PEDIATRICS
Contact information
Practice address
1505 E MAIN ST, STIGLER, OK 74462-2913
(918) 967-3368
(918) 967-3351
Mailing address
PO BOX 179, STIGLER, OK 74462-0179
(918) 967-3368
(918) 967-4582
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
115890
OK
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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