Healthcare Provider Details

I. General information

NPI: 1861885832
Provider Name (Legal Business Name): SHOUNDA TURLEY APRN-NPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2485 N MAIN ST
JAY OK
74346-2201
US

IV. Provider business mailing address

2485 N MAIN ST
JAY OK
74346-2201
US

V. Phone/Fax

Practice location:
  • Phone: 918-253-2550
  • Fax:
Mailing address:
  • Phone: 918-253-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number62610
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0715478
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: