Provider Demographics
NPI:1700630795
Name:MASSEY, SHELBY (MA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11316 N INDIANA AVE APT B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-7945
Mailing Address - Country:US
Mailing Address - Phone:405-834-2937
Mailing Address - Fax:
Practice Address - Street 1:100 S MAIN ST STE 505
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202-3738
Practice Address - Country:US
Practice Address - Phone:405-834-2937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program