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General NPI Number Information
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NPI Number | 1902698798
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Entity Type | Individual
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Provider Name | SHERRY SIDES APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/19/2025
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 11011 E 41ST ST
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City | TULSA
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State | OK
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Zip | 74146-2714
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Country | US
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Telephone | 918-878-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 54394 COUNTY ROAD 586
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City | KANSAS
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State | OK
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Zip | 74347-1321
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Country | US
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Telephone | 580-819-1899
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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 | 222944
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License Number State | OK
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