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General NPI Number Information
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NPI Number | 1699227645
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Entity Type | Individual
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Provider Name | SHERIDAN CLARK CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/25/2016
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 15951 LITTLE AXE DR
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City | NORMAN
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State | OK
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Zip | 73026-9088
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Country | US
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Telephone | 405-447-0300
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Fax | 405-701-7631
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Provider Business Mailing Address
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Address Line | 15951 LITTLE AXE DR
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City | NORMAN
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State | OK
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Zip | 73026-9088
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Country | US
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Telephone | 405-447-0300
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Fax | 405-701-7631
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 207538
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License Number State | OK
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