Healthcare Provider Details

I. General information

NPI: 1477458180
Provider Name (Legal Business Name): JANCIE KRISTEN CUESTA-SHELBURNE APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2026
Last Update Date: 10/12/2026
Certification Date: 10/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 W UNIVERSITY BLVD
DURANT OK
74701-3006
US

IV. Provider business mailing address

323 ARROWHEAD LN
DURANT OK
74701-0853
US

V. Phone/Fax

Practice location:
  • Phone: 580-924-3080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231870
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: