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Last Update: Tuesday, April 30, 2024 10:53 AM CDT
Next Update: Tuesday, April 30, 2024 12:00 PM 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: |
|
|
Status: |
Active |
Status Class: |
Fully Licensed |
Restricted to: |
|
CME Year: |
2025 |
|
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):
|
Name: |
Type: |
License Number: |
Full/Part Time: |
NATASHA KNOWLTON
|
DO |
4422 |
|
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