DR. SHANNON REBEKAH HEADLEY DO MA NPI 1326484015

NPI Information

NPI: 1326484015
Provider Name: DR. SHANNON REBEKAH HEADLEY, DO, MA
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual
Address:
100 S BLISS AVE
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 458-3100
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DR. Shannon Rebekah Headley, DO, MA is a student in an organized health care education training program in Tahlequah, OK. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Shannon Rebekah Headley, DO, MA NPI is 1326484015. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 S BLISS AVE
TAHLEQUAH, OK
ZIP 74464-512
Phone: (918) 458-3100

The enumeration date for this NPI number is 5/21/2013 and was last updated on 6/16/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	208600000X	Surgery		R3534	ARIZONA	No
3	390200000X	Student in an Organized Health Care Education/Training Program			OKLAHOMA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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