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General NPI Number Information
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NPI Number | 1639692254
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Entity Type | Individual
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Provider Name | SHAWN DAVID SAGER NURSE PRACTITIONER
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Gender | Male
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 1801 E KENOSHA ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-2098
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Country | US
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Telephone | 918-449-4150
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Fax | 918-449-4107
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Provider Business Mailing Address
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Address Line | 6600 S YALE AVE STE 1200
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City | TULSA
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State | OK
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Zip | 74136-3361
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 77810
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License Number State | OK
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