Individual
SHAMIKA MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3330 NW 56TH ST, SUITE 300, OKLAHOMA CITY, OK 73112-4479
(405) 945-5275
(405) 945-5232
Mailing address
5300 N INDEPENDENCE AVE, SUITE 280, OKLAHOMA CITY, OK 73112-5556
(405) 945-5275
(405) 945-5232
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
85362
OK
Other
Enumeration date
08/24/2015
Last updated
08/03/2017
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