Provider Demographics
NPI:1033778287
Name:SPIES, SHEENA M
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:M
Last Name:SPIES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHEENA
Other - Middle Name:M
Other - Last Name:KERNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:816 W OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-1662
Mailing Address - Country:US
Mailing Address - Phone:918-720-8213
Mailing Address - Fax:
Practice Address - Street 1:816 W OAKLAND ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-1662
Practice Address - Country:US
Practice Address - Phone:918-720-8213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management