Healthcare Provider Details

I. General information

NPI: 1487519526
Provider Name (Legal Business Name): ROXANNE SHERRILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7936 US HIGHWAY 277
ELGIN OK
73538-2144
US

IV. Provider business mailing address

1178 COUNTY ROAD 1610
MARLOW OK
73055-6412
US

V. Phone/Fax

Practice location:
  • Phone: 580-492-6900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number205225
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: