Individual
SHAWNA ROSE LISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6767 S YALE AVE STE A, TULSA, OK 74136-3302
(918) 492-7587
Mailing address
6767 S YALE AVE STE A, TULSA, OK 74136-3303
(918) 492-9758
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3036
OK
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
04/03/2019
Last updated
04/12/2019
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