Healthcare Provider Details

I. General information

NPI: 1134984438
Provider Name (Legal Business Name): SARAH ABIGAIL WOODY APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2249 W WASHINGTON ST
BROKEN ARROW OK
74012-6703
US

IV. Provider business mailing address

2249 W WASHINGTON ST
BROKEN ARROW OK
74012-6703
US

V. Phone/Fax

Practice location:
  • Phone: 918-960-5335
  • Fax: 949-988-2941
Mailing address:
  • Phone: 918-960-5335
  • Fax: 949-988-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number205286
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: