Organization
SHADOW NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MONICA ALAINE TUCKER (ADMINISTRATOR/OWNER)
(405) 824-1378
Entity
Organization
Contact information
Practice address
2501 N WESTERN AVE, OKLAHOMA CITY, OK 73106-5637
(405) 824-1378
(405) 601-7823
Mailing address
2501 N WESTERN AVE, OKLAHOMA CITY, OK 73106-5637
(405) 824-1378
(405) 601-7823
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
02/20/2014
Last updated
02/20/2014
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