SHANNON RENAE SOMERS

PONCA CITY, OK
NPI1205557303
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: OK  211628)
Additional Taxonomies163W00000X Registered Nurse
(Licence: OK  R0128161)
Enumeration Date2022-09-07
Last Update Date2023-01-31
Business Address
SHANNON RENAE SOMERS
104 S 4TH ST
PONCA CITY, OK 74601-5329
Phone number: 580-382-4034
Mailing Address
SHANNON RENAE SOMERS
104 S 4TH ST
PONCA CITY, OK 74601-5329
Phone number: