Individual
CECILIA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3159 S MADISON AVE, TULSA, OK 74105-2035
(918) 740-2390
Mailing address
3159 S MADISON AVE, TULSA, OK 74105-2035
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
41431
OK
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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