Individual
MS. JERRI LYNN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
540 ILLINOIS ST, PAWNEE, OK 74058-2036
(918) 762-1045
Mailing address
540 ILLINOIS ST, PAWNEE, OK 74058-2036
(918) 762-1045
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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