Provider Demographics
NPI:1831652965
Name:ARNOLD, SHIRLIEJEAN RAVEN (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLIEJEAN
Middle Name:RAVEN
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2514 E 15TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4655
Mailing Address - Country:US
Mailing Address - Phone:918-398-9663
Mailing Address - Fax:
Practice Address - Street 1:2514 E 15TH ST STE A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4655
Practice Address - Country:US
Practice Address - Phone:918-398-9663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-06
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0105697163W00000X
OK105697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse