Healthcare Provider Details

I. General information

NPI: 1053839050
Provider Name (Legal Business Name): SHANNON MARIE WORLEY NAVIGATOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2017
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HOPPE BLVD SUITE 5
ADA OK
74820
US

IV. Provider business mailing address

RESOURCE MANAGEMENT 1300 HOPPE BLVD., SUITE 1
ADA OK
74820
US

V. Phone/Fax

Practice location:
  • Phone: 580-436-1222
  • Fax: 580-436-1333
Mailing address:
  • Phone: 580-436-7211
  • Fax: 580-272-5757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: