Provider Demographics
NPI:1306731179
Name:KIRKLAND, SHAYNA BETH (LPN)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:BETH
Last Name:KIRKLAND
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHAYNA
Other - Middle Name:BETH
Other - Last Name:RAINWATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2 E CLARK BASS BLVD
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4282
Mailing Address - Country:US
Mailing Address - Phone:888-397-8387
Mailing Address - Fax:918-577-4726
Practice Address - Street 1:2 E CLARK BASS BLVD
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4282
Practice Address - Country:US
Practice Address - Phone:888-397-8387
Practice Address - Fax:918-577-4726
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0055569164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse