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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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GRAY, SHYVONNE NASHELLE-RUTH       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 4013 NW EXPRESSWAY
STE 105
OKLAHOMA CITY OK 73116

Address last updated on 6/4/2024
Phone #: (405) 378-2727
Fax #: (405) 378-2776
County: OKLAHOMA
License: 27895
Dated: 7/1/2011
Expires: 7/1/2025
License Type: Medical Doctor
Specialty: Psychiatry
Status: Active
Status Class: Fully Licensed
Restricted to:
Registered to Dispense: YES
Medical School: Univ Of Ok Coll Of Med, Oklahoma City Ok 73190
Graduated: 5 / 2010
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY
New Patients: Yes
Medicaid: No
Medicare: No
   
HMO/PPO: Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
CIGNA PPO
HealthChoice
United Healthcare Choice
Hospital Privileges: Hospital Not Listed
,
Locations: Hours: Languages:
4013 NW EXPRESSWAY
STE 105
OKLAHOMA CITY OK 73116

Phone #: (405) 378-2727
Fax #: (405) 378-2776
Mon: 7:30AM - 5:00PM
Tue: 7:30AM - 5:00PM
Wed: 7:30AM - 5:00PM
Thu: 7:30AM - 5:00PM
Fri: 7:30AM - 5:00PM
Sat:
Sun:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
TERESA BETH MILLER PA 1699
COLBY PACHECO APRN 10976

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