Individual
DYLAN SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1125 N PORTER AVE STE 301, NORMAN, OK 73071-6443
(405) 503-0366
Mailing address
1125 N PORTER AVE STE 301, NORMAN, OK 73071-6443
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
113527
OK
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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