Provider Demographics
NPI:1396253043
Name:ONIGBINDE, CORINNE (PA-C)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:ONIGBINDE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:
Other - Last Name:PARKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1923 S UTICA AVE
Mailing Address - Street 2:CREDENTIALING OFC, GROUND FL
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-6520
Mailing Address - Country:US
Mailing Address - Phone:918-403-7065
Mailing Address - Fax:918-744-2946
Practice Address - Street 1:800 W BOISE CIR STE 160
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-4932
Practice Address - Country:US
Practice Address - Phone:918-994-9160
Practice Address - Fax:918-403-6306
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2873363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant