Logan, Shawna Marissa

Logan, Shawna Marissa is an individual health care provider with primary practice located at 1101 Hillcrest Dr , Woodward OK 73801-3027. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Logan, Shawna Marissa can be contacted via phone (580) 254-8600.

Contact Information

Primary practice address
1101 Hillcrest Dr Woodward OK 73801-3027
Phone: (580) 254-8600
Fax: (580) 571-8085
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 74435-ARNP Oklahoma

Profile Details

NPI number 1063749018
LBN Legal business name Logan, Shawna Marissa
Credentials FAMILY NURSE PRACTIO
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 12th, 2009
Last updated Oct 20th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063749018 NPPES
Oklahoma MEDICAID 200264990A

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