Individual
SHANNON RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, RD/LD, CDCES
Contact information
Practice address
4300 W MEMORIAL RD, OKLAHOMA CITY, OK 73120-8304
(405) 936-5402
Mailing address
4300 W MEMORIAL RD, OKLAHOMA CITY, OK 73120-8304
(405) 936-5402
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
107398
OK
Other
Enumeration date
02/25/2021
Last updated
02/26/2021
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