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Individual

SHANNON MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-CNP

Contact information

Practice address
1600 SW 119TH ST, OKLAHOMA CITY, OK 73170-4908
(405) 425-8100
(405) 425-8109
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 425-8100
(405) 425-8109

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
78164
OK
363LF0000X
Family Nurse Practitioner
Primary
78164
OK

Other

Enumeration date
06/05/2013
Last updated
11/08/2019
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