Provider Demographics
NPI:1225824360
Name:MITCHELL, SHAWNA LANEE
Entity type:Individual
Prefix:
First Name:SHAWNA
Middle Name:LANEE
Last Name:MITCHELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12306 E 87TH ST N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2040
Mailing Address - Country:US
Mailing Address - Phone:918-373-4374
Mailing Address - Fax:
Practice Address - Street 1:12306 E 87TH ST N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-2040
Practice Address - Country:US
Practice Address - Phone:918-373-4374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist