Individual
SHELBY WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4012
(918) 579-8000
Mailing address
2709 W CHARLOTTE ST, BROKEN ARROW, OK 74011-6133
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
220184
OK
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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