Healthcare Provider Details

I. General information

NPI: 1770439812
Provider Name (Legal Business Name): SABRINA WOODY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 05/03/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SW 30TH CT
MOORE OK
73160-2887
US

IV. Provider business mailing address

1707 WINDING RIDGE RD
EDMOND OK
73034-1407
US

V. Phone/Fax

Practice location:
  • Phone: 801-471-3890
  • Fax:
Mailing address:
  • Phone: 801-471-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number227976
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: