Individual
SHELLEY TUMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 216-4999
Mailing address
1524 MELISSA CIR, SAPULPA, OK 74066-2512
(918) 508-8376
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
59243
OK
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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