Individual
ASHLEY ANN SHOPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
615 E MAIN ST, JENKS, OK 74037-4138
(918) 299-8080
(918) 298-2838
Mailing address
615 E MAIN ST, JENKS, OK 74037-4138
(918) 299-8080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1345
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200022130A
—
OK
Enumeration date
02/08/2006
Last updated
05/19/2015
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