Provider Demographics
NPI:1821525718
Name:WRIGHT, SHELBY LANEE (APRN, NP-C)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LANEE
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 TOPAZ AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1887
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 W 6TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4376
Practice Address - Country:US
Practice Address - Phone:405-742-5888
Practice Address - Fax:405-533-6074
Is Sole Proprietor?:No
Enumeration Date:2017-05-22
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK108108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily