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1487112603
SHANTEL LANIECE BOLTON
TULSA, OK
NPI
1487112603
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OK 95457)
Enumeration Date
2019-03-06
Last Update Date
2024-04-22
Business Address
SHANTEL LANIECE BOLTON APRN
7600 S LEWIS AVE
TULSA, OK 74136-6836
Phone number: 539-399-3410
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Mailing Address
SHANTEL LANIECE BOLTON APRN
7600 S LEWIS AVE
TULSA, OK 74136-6836
Phone number: 539-399-3410
Copy
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