Healthcare Provider Details

I. General information

NPI: 1518304278
Provider Name (Legal Business Name): TONYA MARIA MARTIN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TONYA MARIA MARTIN FNP-BC

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 S SYCAMORE AVE
BROKEN ARROW OK
74011-6037
US

IV. Provider business mailing address

6601 S SYCAMORE AVE
BROKEN ARROW OK
74011-6037
US

V. Phone/Fax

Practice location:
  • Phone: 918-269-9180
  • Fax:
Mailing address:
  • Phone: 918-269-9180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231332
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: