Healthcare Provider Details

I. General information

NPI: 1538074927
Provider Name (Legal Business Name): SHARNELL K SANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8921 S MINGO RD
TULSA OK
74133-5841
US

IV. Provider business mailing address

22749 E 141ST ST S
COWETA OK
74429-6235
US

V. Phone/Fax

Practice location:
  • Phone: 918-252-8019
  • Fax: 918-254-9540
Mailing address:
  • Phone: 918-381-3465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR0056128
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: