Provider Demographics
NPI:1609671197
Name:VORLAND, SHELLIE
Entity type:Individual
Prefix:
First Name:SHELLIE
Middle Name:
Last Name:VORLAND
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 E REDBUD DR APT 110C
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-5720
Mailing Address - Country:US
Mailing Address - Phone:817-504-8790
Mailing Address - Fax:
Practice Address - Street 1:998 E KNOTTS AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-3023
Practice Address - Country:US
Practice Address - Phone:539-242-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator