Basic Information
| Provider Information | |||||||||
| NPI: | 1427316017 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | NICOLE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | L.P.N. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 401 E BROADWAY CT | ||||||||
| Address2: | STE. E | ||||||||
| City: | SAND SPRINGS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740637939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182455565 | ||||||||
| FaxNumber: | 9182455564 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 E BROADWAY CT | ||||||||
| Address2: | STE. E | ||||||||
| City: | SAND SPRINGS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740637939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9182455565 | ||||||||
| FaxNumber: | 9182455564 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2012 | ||||||||
| LastUpdateDate: | 05/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 0053909 | OK | Y | Nursing Service Providers | Licensed Practical Nurse |
No ID Information.