Individual
SHANA HARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
803 N FOREMAN ST, SUITE 102, VINITA, OK 74301-1435
(918) 256-2261
(918) 256-2304
Mailing address
803 N FOREMAN ST, SUITE 102, VINITA, OK 74301-1435
(918) 256-2261
(918) 256-2304
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
75871
OK
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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