Healthcare Provider Details

I. General information

NPI: 1821924465
Provider Name (Legal Business Name): SHARA MARIE ROLLINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 SE 4TH ST
LEXINGTON OK
73051-8614
US

IV. Provider business mailing address

PO BOX 2274
ADA OK
74821-2274
US

V. Phone/Fax

Practice location:
  • Phone: 405-833-0064
  • Fax:
Mailing address:
  • Phone: 580-344-6198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: