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General NPI Number Information
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NPI Number | 1598563744
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Entity Type | Individual
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Provider Name | SHELLY SCHRECK
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Gender |
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 651 STANTON L YOUNG BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104
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Country | US
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Telephone | 405-271-6623
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Fax |
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Provider Business Mailing Address
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Address Line | 18800 TRAILVIEW WAY
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City | EDMOND
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State | OK
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Zip | 73012-2504
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Country | US
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Telephone | 623-432-2749
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R0122604
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 224893
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License Number State | OK
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