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Last Update: Tuesday, April 16, 2024 3:07 PM CDT
Next Update: Wednesday, April 17, 2024 2:50 AM CDT
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BANKSTON, TIFFANY NICOLE |
| Practice Address: |
13301 N MERIDIAN AVENUE STE 300A
OKLAHOMA CITY OK 73120-+000
Address last updated on 3/26/2024 |
| Phone #: |
(405) 849-5391 |
| Fax #: |
|
| County: |
OKLAHOMA |
| License: |
1478 |
| Dated: |
4/1/2006 |
| Expires: |
3/31/2025 |
|
Temp.
Ltr.
Issued:
|
11/4/2005 |
|
Temp.
Ltr.
Expires:
|
5/13/2006 |
| License Type: |
Physician Assistant |
| Specialty: |
|
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
|
| CME Year: |
2025 |
|
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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Hospital Privileges:
Lakeside Women's Hospital
Oklahoma City, OK
Oklahoma Surgicare
Oklahoma City, OK
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Primary Supervisor(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
|
NATASHA KNOWLTON
|
DO |
4422 |
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