Provider Demographics
NPI:1497341895
Name:POPE, SHELBY ANN (APRN-CNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:ANN
Last Name:POPE
Suffix:
Gender:F
Credentials:APRN-CNP, FNP-BC
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:ANN
Other - Last Name:MCKINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12296 N 52ND WEST AVE
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-6329
Mailing Address - Country:US
Mailing Address - Phone:620-779-1759
Mailing Address - Fax:
Practice Address - Street 1:1501 W ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:SKIATOOK
Practice Address - State:OK
Practice Address - Zip Code:74070-3924
Practice Address - Country:US
Practice Address - Phone:918-396-4122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-19
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK202138363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily