# SHADOW NURSING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982029476
- **Authorized official:** MRS. MONICA ALAINE TUCKER (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (405) 824-1378

## Contact information

- **Practice address:** 2501 N WESTERN AVE, OKLAHOMA CITY, OK 73106-5637
- **Practice address phone:** (405) 824-1378
- **Practice address fax:** (405) 601-7823
- **Mailing address:** 2501 N WESTERN AVE, OKLAHOMA CITY, OK 73106-5637
- **Mailing address phone:** (405) 824-1378
- **Mailing address fax:** (405) 601-7823

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | Yes |

## Other

- **Enumeration date:** 02/20/2014
- **Last updated:** 02/20/2014