Individual
MS. SHANNON GALE DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN CNP FAMILY
Contact information
Practice address
3414 NW 135TH ST, OKLAHOMA CITY, OK 73120-4009
(405) 749-0900
(405) 749-0913
Mailing address
3414 NW 135TH ST, OKLAHOMA CITY, OK 73120-4009
(405) 749-0900
(405) 749-0913
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0069234
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200437870A
—
OK
01
—
R0069234
STATE LICENSE
OK
Enumeration date
10/12/2011
Last updated
02/17/2020
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