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Individual

HOLLY NICOLE SHINNEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
519 N MAIN ST STE 102, BRISTOW, OK 74010-2016
(918) 367-6611
(918) 367-9915
Mailing address
6600 S YALE AVE STE 1400, TULSA, OK 74136-3331
(888) 247-0125
(918) 502-8210

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1517
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200225650A
OK
01
P01099343
MEDICARE RAILROAD
OK
Enumeration date
06/21/2007
Last updated
11/13/2023
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