Provider Demographics
NPI:1649684960
Name:VOORHEES, SHAWNYA DEE (RPH)
Entity type:Individual
Prefix:
First Name:SHAWNYA
Middle Name:DEE
Last Name:VOORHEES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-5015
Mailing Address - Country:US
Mailing Address - Phone:405-282-1051
Mailing Address - Fax:
Practice Address - Street 1:1608 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-5015
Practice Address - Country:US
Practice Address - Phone:405-282-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-14
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10653183500000X
TN11866183500000X
CO20268183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20268OtherPHARMACY LICENSE NUMBER
TN11866OtherPHARMACY LICENSE NUMBER
OK10653OtherPHARMACY LICENSE NUMBER