Individual
SHANICE MAYFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1803 S WOOD DR, OKMULGEE, OK 74447-6825
(918) 756-9250
Mailing address
609 E 13TH ST, OKMULGEE, OK 74447-6039
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0101027
OK
Other
Enumeration date
01/02/2013
Last updated
01/02/2013
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