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General NPI Number Information
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NPI Number | 1154030724
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Entity Type | Organization
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Legal Business Name | LTCNP
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Dates
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Enumeration Date | 11/22/2022
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 14355 W CRESCENT DOVER RD
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City | CRESCENT
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State | OK
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Zip | 73028
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Country | US
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Telephone | 405-650-5561
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Fax | 405-400-2559
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Provider Business Mailing Address
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Address Line | 14355 W CRESCENT DOVER RD
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City | CRESCENT
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State | OK
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Zip | 73028-3311
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Country | US
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Telephone |
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Fax | 405-400-2559
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON DUNN
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Credential | DNP
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Telephone | 405-560-5561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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