Individual
TASHA SHEA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2225 N. UNION, PONCA CITY, OK 74601-1536
(580) 308-5515
(580) 749-5792
Mailing address
2225 N. UNION, PONCA CITY, OK 74601-1536
(580) 308-5515
(580) 749-5792
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
109192
OK
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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