Healthcare Provider Details

I. General information

NPI: 1043151525
Provider Name (Legal Business Name): TAMMY LEEANN KAIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12400 SW 15TH ST
YUKON OK
73099-7734
US

IV. Provider business mailing address

1900 E DOWDEN LN
MUSTANG OK
73064-6501
US

V. Phone/Fax

Practice location:
  • Phone: 405-376-7856
  • Fax:
Mailing address:
  • Phone: 405-376-7856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR0073843
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: