Shanda Alls

Individual provider Active NPI Licensed Practical Nurse · Moore, OK

NPI 1467262188 · NPPES record last updated Jan 14, 2025

Key facts

NPI
1467262188
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L0060003 (OK)
Practice address
805 N Platt Cir
Moore, OK 73170-1115
Phone
(405) 953-3265
NPI assigned
Jan 14, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L0060003OKMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Recovery Care Clinic/Center 261QR0800X
Peer Specialist 175T00000X
Licensed Practical Nurse 164W00000X L0060003 OK Yes

Addresses

Primary practice location

805 N Platt Cir
Moore, OK 73170-1115

Mailing address

805 N Platt Cir
Moore, OK 73170-1115
Phone (405) 953-3265

Other providers in Moore, OK

All providers in Moore, OK · Licensed Practical Nurse in Oklahoma

Sources for this page

Verify at the official NPI Registry.