Healthcare Provider Details

I. General information

NPI: 1740030261
Provider Name (Legal Business Name): KRISTI R SHOCKLEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2024
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W TECUMSEH RD STE 300
NORMAN OK
73072-1812
US

IV. Provider business mailing address

PO BOX 1330
NORMAN OK
73070-1330
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-5700
  • Fax:
Mailing address:
  • Phone: 405-307-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number217276
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number217276
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: