Individual
MICHELLE DESHAZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
124 N MICKEY MANTLE BLVD, COMMERCE, OK 74339-1106
(918) 961-0750
Mailing address
124 N MICKEY MANTLE BLVD, COMMERCE, OK 74339-1106
(918) 961-0750
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0108670
OK
163W00000X
Registered Nurse
RN2003006810
MO
Other
Enumeration date
10/16/2015
Last updated
11/11/2015
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