Individual
MRS. SHAWNA MARISSA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1101 HILLCREST DR, WOODWARD, OK 73801-3027
(580) 256-3608
Mailing address
1101 HILLCREST DR, WOODWARD, OK 73801-3027
(580) 256-3608
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0074435
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200264990A
—
OK
Enumeration date
11/12/2009
Last updated
10/29/2024
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