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Individual

SHANNON SHAVONNE RAINES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
909 ALAMEDA ST, NORMAN, OK 73071-5229
(405) 351-6000
Mailing address
1565 COUNTY ROAD 1480, NINNEKAH, OK 73067-4021
(405) 222-9898

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OK
172V00000X
Community Health Worker

Other

Enumeration date
10/17/2017
Last updated
10/17/2017
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