Individual
SHANAN ZICKEFOOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, COSMETIC TATTOO
Contact information
Practice address
3319 E 46TH ST, SUITE 100, TULSA, OK 74135-7413
(918) 724-5614
Mailing address
3319 E 46TH ST STE 100, TULSA, OK 74135-2924
(918) 724-5614
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0120266
OK
246ZA2600X
Medical Art Specialist/Technologist
Primary
1132
OK
246ZA2600X
Medical Art Specialist/Technologist
Primary
1132
—
Other
Enumeration date
03/22/2012
Last updated
04/17/2026
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