Healthcare Provider Details

I. General information

NPI: 1073424404
Provider Name (Legal Business Name): SARAH ANN CHAVEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1709 W 33RD ST
EDMOND OK
73013-3861
US

IV. Provider business mailing address

2104 NW 172ND ST
EDMOND OK
73012-7154
US

V. Phone/Fax

Practice location:
  • Phone: 405-229-8209
  • Fax:
Mailing address:
  • Phone: 405-301-6199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number231484
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: