| Doctor Name: | MRS. SHAWNA MARISSA LOGAN |
| NPI Number: | 1063749018 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FAMILY NURSE PRACTIO |
| License Number: | 74435-ARNP |
| Business Practice Address: | 1101 Hillcrest Dr Woodward, OK - 738013027 |
| Business Phone Number: | 5802548600 |
| Business Fax Number: | 5805718085 |
| Mailing Address: | 1101 Hillcrest Dr, WOODWARD |
| State: | OK |
| Postal Code: | 738013027 |
| Phone Number: | 5802548600 |
| Fax Number: | |
| NPI Enumeration Date: | 11/12/2009 |
| NPI Last Update Date: | 08/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 74435-ARNP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |