NEW IDENTITY FOUNDATION

OKLAHOMA CITY, OK
NPI1184586125
Other NameSHADOW NURSING INC
Entity TypeOrganization
Authorized ContactMONICA A. TUCKER
RN Administration
405-824-1378
Organization Subpart ?No
Primary Taxonomy163WM1400X Registered Nurse, Nurse Massage Therapist (NMT)
Additional Taxonomies163WA2000X Registered Nurse, Administrator
163WC0400X Registered Nurse, Case Management
171M00000X Case Manager/Care Coordinator
Enumeration Date2025-11-28
Last Update Date2025-11-28
Business Address
NEW IDENTITY FOUNDATION
613 NW 117TH ST
OKLAHOMA CITY, OK 73114-7922
Phone number: 405-824-1378
Mailing Address
NEW IDENTITY FOUNDATION
1211 PINE VLY
EDMOND, OK 73012-4364
Phone number: 405-824-1378