MEDICARE: TAUSHA ZANN SHELTON ARNP-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R0054948	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023251360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAUSHA ZANN SHELTON ARNP-CNP

Provider Business Mailing Address
First Line	:	731 12TH AVE NW
Second Line	:	SUITE #201
City	:	ARDMORE
State	:	OK
Zip	:	73401-5761
Country	:	US
Telephone Number	:	580-224-9000
Fax Number	:	580-224-9009

Provider Business Practice Location Address
First Line	:	1116 WALNUT DR
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-2353
Country	:	US
Telephone Number	:	580-226-0543
Fax Number	:	580-226-2284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2009
Last Update Date	:	09/21/2022

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