COSTULAS, ALENA NICOLE - Licensee Information

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Last Update: Sunday, May 12, 2024 4:03 AM CDT
Next Update: Sunday, May 12, 2024 12:00 PM CDT

COSTULAS, ALENA NICOLE

Practice Address:	MERCY PRIMARY CARE 520 SOUTH MUSTANG RD YUKON OK 73099 Address last updated on 2/19/2024
Phone #:	(405) 936-5910
Fax #:
County:	CANADIAN
License:	4902
Dated:	11/1/2022
Expires:	3/31/2025
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.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
MERCY PRIMARY CARE 520 SOUTH MUSTANG RD YUKON OK 73099 Phone #: (405) 936-5910 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
NESTOR FERNANDEZ PINAROC	MD	19456

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European Union Residents - GDPR Notice: In accordance with the Oklahoma Open Records Act, all applications submitted are a matter of public record. Social Security Numbers and any HIPAA-protected data are redacted. By applying for and retaining an Oklahoma Medical License, you are giving consent to share your information with anyone requesting it and waiving your right to be notified when your data is requested. We are also required to retain licensee records for a minimum of 10 years after the license expires, so any information submitted will remain a public record for that time period.

Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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