Individual
MRS. LISA MARIE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6839 S CANTON AVE, TULSA, OK 74136-3402
(918) 494-0612
Mailing address
8429 S COLLEGE AVE, TULSA, OK 74137-1451
(918) 704-4414
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
82540
OK
Other
Enumeration date
07/18/2006
Last updated
04/16/2015
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