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Individual

SHAMIA PELTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10605 E 66TH ST APT 224, TULSA, OK 74133-2641
(991) 622-8010
Mailing address
3171 S 129TH EAST AVE, TULSA, OK 74134-3205

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
200437
OK
164X00000X
Licensed Vocational Nurse
Primary
699148
CA

Other

Enumeration date
05/28/2022
Last updated
05/28/2022
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