Provider Information for 1053808923
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DEBORAH L SHARP
Sex: Female
NPI: 1053808923
Last Updated: 2024-12-03
Certification Date: 2024-12-03
Certification Date: 2024-12-03
Details
| Name | Value | ||||||||||||
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| NPI | 1053808923 | ||||||||||||
| Enumeration Date | 2018-04-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 3908 N AYDELOTTE AVE SHAWNEE, OK 74804-1620 United States Phone: 405-434-2301 | Fax: | ||||||||||||
| Primary Practice Address | 624 W INDEPENDENCE ST STE 105 SHAWNEE, OK 74804-4329 United States Phone: 405-434-2301 | Fax: | ||||||||||||
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