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Individual

MRS. JILLIAN RUSSELL SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
825 NE 10TH ST, OKLAHOMA CITY, OK 73104-5417
(918) 398-1054
Mailing address
7000 N PORTLAND AVE, OKLAHOMA CITY, OK 73116-2039
(918) 398-1054

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
216836
OK

Other

Enumeration date
03/07/2024
Last updated
03/07/2024
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