Individual
SHANNON NICOLE DELLOIACONO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1809 E 13TH ST, STE. 400, TULSA, OK 74104-4419
(918) 599-8200
(918) 583-4678
Mailing address
1809 E 13TH ST, STE. 400, TULSA, OK 74104-4419
(918) 599-8200
(918) 583-4678
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1102551
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200511350A
—
OK
Enumeration date
12/19/2011
Last updated
05/01/2014
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