Provider Demographics
NPI:1801779251
Name:CONDIT, SHAYLON NICOLE
Entity type:Individual
Prefix:
First Name:SHAYLON
Middle Name:NICOLE
Last Name:CONDIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7127 N COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:OK
Mailing Address - Zip Code:73078-9136
Mailing Address - Country:US
Mailing Address - Phone:580-297-0166
Mailing Address - Fax:580-297-0166
Practice Address - Street 1:7127 N COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:OK
Practice Address - Zip Code:73078-9136
Practice Address - Country:US
Practice Address - Phone:580-297-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist