1669964433 NPI number — KINDFUL HOSPICE SAPULPA TULSA, LLC

Table of content: TASHA MARIE WILLENS LPC (NPI 1427771781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669964433 NPI number — KINDFUL HOSPICE SAPULPA TULSA, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KINDFUL HOSPICE SAPULPA TULSA, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669964433
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6760 OLD JACKSONVILLE HWY STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TYLER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75703-0566
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-363-9932
Provider Business Mailing Address Fax Number:
817-326-2436

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8010 S 101ST EAST AVE STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74133-4562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-512-8388
Provider Business Practice Location Address Fax Number:
918-512-8460
Provider Enumeration Date:
06/06/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANDLIN
Authorized Official First Name:
KATIE
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR OF COMPLIANCE
Authorized Official Telephone Number:
903-714-3439

Provider Taxonomy Codes

  • Taxonomy code: 251G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)