IndividualActive
Shanon Paxson
NPI 1376740019 · Private Vehicle · Grove, OK
Provider details
- NPI number
- 1376740019
- Entity type
- Individual
- Primary specialty
- Private VehicleTransportation Services
- Sex
- Female
- Sole proprietor
- Yes
- License
- 1000670490A (OK)
Specialties & taxonomies
Transportation Services
- Intellectual and/or Developmental Disabilities Residential Treatment Facility320600000XLicense 1000670490A (OK)
Residential Treatment Facilities
Practice location
25322 S 603 Rd
Grove, OK 74344
Phone: (918) 787-4368
Approximate (ZIP-level) locationGet directions
Mailing address
25322 S 603 Rd
Grove, OK 74344
Registry dates
- Enumerated
- 2007-06-27
- Last updated
- 2025-09-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.