Basic Information
| Provider Information | |||||||||
| NPI: | 1629231519 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILLIER | ||||||||
| FirstName: | SHANNON | ||||||||
| MiddleName: | LYNNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2448 E 81ST ST | ||||||||
| Address2: | SUITE 3700 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741374250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182364000 | ||||||||
| FaxNumber: | 9182364001 | ||||||||
| Practice Location | |||||||||
| Address1: | 2448 E 81ST ST | ||||||||
| Address2: | SUITE 3700 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741374250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182364000 | ||||||||
| FaxNumber: | 9182364001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2008 | ||||||||
| LastUpdateDate: | 05/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 6091 | OK | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.