Healthcare Provider Details

I. General information

NPI: 1316214430
Provider Name (Legal Business Name): TONYA L HOUSTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TONYA L KINARD-COTTMAN

II. Dates (important events)

Enumeration Date: 11/17/2011
Last Update Date: 06/13/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 POND CIR
SAND SPRINGS OK
74063-7784
US

IV. Provider business mailing address

2320 POND CIR
SAND SPRINGS OK
74063-7784
US

V. Phone/Fax

Practice location:
  • Phone: 256-770-5420
  • Fax: 918-268-6294
Mailing address:
  • Phone: 256-770-5420
  • Fax: 918-268-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-165361
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberR63708
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number63708
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: