| Organization Name: | SHANNON G. DAVIS, APRN-CNP FAMILY, P.L.L.C |
| NPI Number: | 1508292210 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANNON GALE DAVIS (FAMILY NURSE PRACTITIONER) |
| Mailing Address: | 201 N Main St Yale |
| State: | OK US |
| Postal Code: | 740852509 |
| Phone Number: | 4054141441 |
| Fax Number: | 4052609566 |
| NPI Enumeration Date: | 09/25/2013 |
| NPI Last Update Date: | 07/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | R69234 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |