SHANNON BALLOU (NPI# 1255708012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255708012 |
| Entity Type | Individual |
| Full Name | SHANNON BALLOU |
| Credential | APRN, FNP-C |
| Practice Address |
3811 W Gore Blvd Ste 6 Lawton OK 73505-6328 |
| Practice Telephone | 5802506525 |
| Mailing Telephone | 5802506525 |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2015-08-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
106662 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3811 W GORE BLVD STE 6 |
| City | LAWTON |
| State | OK |
| Zip Code | 73505-6328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
| 1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
| 1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
| 1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
| 1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
| 1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
| 1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
| 1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
| 1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
| 1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
| Find all providers in zip 73505 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414628 | Kimberly Noelle Hanley | Nurse Practitioner | 4411 W Gore Blvd Ste A, Lawton, OK 73505-6016 | 2020-07-08 |
| 1871133835 | Jeannie Marie Wyrick | Nurse Practitioner | 1805 Nw Arlington Ave, Lawton, OK 73507-6310 | 2020-01-07 |
| 1780234690 | Candace Michelle Flournoy | Nurse Practitioner | 3201 W Gore Blvd Ste 103, Lawton, OK 73505-6350 | 2019-09-13 |
| 1073071940 | Kimberly Ann Turnipseed | Nurse Practitioner | 6104 Nw Williams Ave, Lawton, OK 73505-1320 | 2019-03-08 |
| 1962980631 | Piettra Santos Alves | Nurse Practitioner | 5606 Sw Lee Blvd Ste 301, Lawton, OK 73505-9618 | 2018-08-03 |
| 1639670649 | Isabelle Zlatnik | Nurse Practitioner | 4411 W Gore Blvd Ste B1, Lawton, OK 73505-5977 | 2018-02-25 |
| 1932627387 | Tonya Bardsher | Nurse Practitioner | 916 Sw 38th St Ste D, Lawton, OK 73505-7005 | 2017-09-06 |
| 1063882140 | Theleka Williams | Nurse Practitioner | 6744 Nw Cache Rd, Lawton, OK 73505-2702 | 2015-10-01 |
| 1437553252 | Ada Diann Johnson | Nurse Practitioner | 5050 Sw Lee Blvd, Lawton, OK 73505 | 2014-10-22 |
| 1902207798 | Marina Nicole Garrison | Nurse Practitioner | 3428 Nw Cache Rd, Lawton, OK 73505-3846 | 2014-09-11 |
| Find all providers in LAWTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.