Kristina Marie Stout, APRN-CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

210451 Issued in OK

Practice address

11917 S Norwood Ave Ste 112
Tulsa, OK 74137-5509

Phone

(918) 779-0642

Fax

(918) 393-8002

NPI assigned

Dec 5, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kristina Marie Corriveau Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Warren Clinic Inc

  • General Practice Physician
  • Tulsa, OK
  • NPI 1174582282
  NPD
• Divine Health and Wellness, LLC

  • Health Service Clinic/Center
  • Sapulpa, OK
  • NPI 1790528164
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1629789276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11917 S NORWOOD AVE STE 112",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375509",
            "telephone_number": "918-779-0642",
            "fax_number": "918-393-8002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11917 S NORWOOD AVE STE 112",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741375509",
            "telephone_number": "918-779-0642",
            "fax_number": "918-393-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOUT",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "210451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "CORRIVEAU",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haley Alexandra Stotts, MA CC SLP
• Sierra Lynn Stouffer, PA-S
• Dana Marie Stournaras, APRN
• David Stout, PTA
• Katie Stout, DPT, ATC
• Reed Michael Stout
• Sarah Stout
• Sophia Stout, DPT
• Timothy Ray Stout
• Catherine Ann Stow

• Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.