Provider Demographics
NPI:1801192067
Name:CLORAN, SHAILYNNE ESTELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHAILYNNE
Middle Name:ESTELLE
Last Name:CLORAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:SHAILYNNE
Other - Middle Name:ESTELLE
Other - Last Name:KLICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9800 BROADWAY EXTENSION
Mailing Address - Street 2:SUITE 201
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6304
Mailing Address - Country:US
Mailing Address - Phone:405-424-5415
Mailing Address - Fax:405-424-5416
Practice Address - Street 1:9800 BROADWAY EXTENSION
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6304
Practice Address - Country:US
Practice Address - Phone:405-424-5415
Practice Address - Fax:405-424-5416
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPA1961363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical