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TABATHYA LANE APRN
NPI 1528896396
Nurse Practitioner - Psychiatric/Mental Health in Kingston, OK

Active since July 23, 2024
9118 BUCKALOO BEND RD, KINGSTON, OK 73439(580) 504-3090 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2024, Jul 23, 2024 (2 updates tracked since 2024).

About Tabathya Lane Aprn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABATHYA LANE APRN (NPI 1528896396), doing business as Evergrace Health And Wellness, is a healthcare organization registered as a psychiatric/mental health in Kingston, Oklahoma and active in the NPI registry since July 2024. The organization lists Tabathya Starr Taliaferro, Sole Owner, as its authorized official.

NPPES Registry Identity

NPI1528896396
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameTABATHYA LANE APRN
Location Address9118 BUCKALOO BEND RDKingston, OK 73439-2021
Mailing Address9118 Buckaloo Bend RdKingston, OK 73439-2021 · (580) 504-3090
Phone(580) 504-3090
Organization SubpartNo
Authorized OfficialTabathya Starr TaliaferroSole Owner · (580) 504-3090
Enumeration DateJuly 23, 2024
Last NPPES UpdateJuly 31, 20252 updates tracked since enumeration
NPPES CertifiedJuly 31, 2025
✔ NPI 1528896396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
Also ListedClinical Nurse Specialist · Family HealthTaxonomy 364SF0001X
9118 BUCKALOO BEND RD, Kingston, OK 73439
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Other Names 1

Doing Business AsEvergrace Health And Wellness

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tabathya Lane Aprn's NPI number?

The NPI number for Tabathya Lane Aprn is 1528896396. It was assigned to this organization in the NPPES registry on July 23, 2024. The provider is doing business as Evergrace Health And Wellness.

Where is Tabathya Lane Aprn located?

Tabathya Lane Aprn is located at 9118 Buckaloo Bend Rd, Kingston, OK 73439. The listed phone number is (580) 504-3090.

What is Tabathya Lane Aprn's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Tabathya Lane Aprn was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.