| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHASTA DAVIS | 1811503329 | 2020-09-20 |
Shasta Davis is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1811503329. Registration indicates Shasta Davis is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse, ) (All Other Specialties & Provider Types, ) (Registered Nurse, Nursing Service Providers) Access to Mental Health/Behavioral Health Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Shasta Davis PMHNP-BC |
| Practice Office Address | 909 ALAMEDA ST NORMAN, OK US |
| Practice Office Telephone | 4053605100 |
| Mailing Address | PO BOX 400 NORMAN, OK 730700400 US |
| Business Telephone | 4053605100 |
| Code | Practice | License No State |
|---|---|---|
| 163W00000X | Nursing Service Providers Registered Nurse Registered Nurse All Other Specialties & Provider Types Registered Nurse Nursing Service Providers | R0134719
OK |
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 215762
OK |