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General NPI Number Information
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NPI Number | 1184594061
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Entity Type | Individual
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Provider Name | SHANNON RENEE DRAYTON
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Gender | Female
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 405-863-4463
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Fax |
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Provider Business Mailing Address
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Address Line | 6513 CROOKED OAK DR
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City | NORMAN
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State | OK
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Zip | 73026-0854
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Country | US
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Telephone | 405-863-4463
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R0090931
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License Number State | OK
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