Healthcare Provider Details

I. General information

NPI: 1144130824
Provider Name (Legal Business Name): NORTH ROCK CREEK SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42400 GARRETTS LAKE RD
SHAWNEE OK
74804-9301
US

IV. Provider business mailing address

42400 GARRETTS LAKE RD
SHAWNEE OK
74804-9301
US

V. Phone/Fax

Practice location:
  • Phone: 405-275-3473
  • Fax:
Mailing address:
  • Phone: 405-275-3473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMBER ROSSER
Title or Position: DIRECTOR OF STUDENT SERVICES
Credential:
Phone: 405-275-3473