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NPI Code Detail

MEDICARE: SHAUNA SHORMAN

MEDICARE:   SHAUNA  SHORMAN
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
1175T00000XPeer Specialist

General Provider Information

NPI Number : 1497288914
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAUNA SHORMAN
Provider Business Mailing Address
First Line : 3217 NW 47TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5939
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3217 NW 47TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-5939
Country : US
Telephone Number : 405-215-0312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2017
Last Update Date : 04/11/2017

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Directions to “ SHAUNA SHORMAN ” Practice Location

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