Basic Information
| Provider Information | |||||||||
| NPI: | 1861454274 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STANSIFER | ||||||||
| FirstName: | SHERYL | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11224 S LOCUST AVE | ||||||||
| Address2: | |||||||||
| City: | JENKS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740372096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9189065558 | ||||||||
| FaxNumber: | 9185605791 | ||||||||
| Practice Location | |||||||||
| Address1: | 11224 S LOCUST AVE | ||||||||
| Address2: | |||||||||
| City: | JENKS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740372096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9189065558 | ||||||||
| FaxNumber: | 9185605791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 04/02/2012 | ||||||||
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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 | 363L00000X | R0076428 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.