Provider Demographics
NPI:1750530036
Name:RICHARDSON, SHERRI LYNN (DNP, APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LYNN
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:DNP, APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 W URBANA ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-5997
Mailing Address - Country:US
Mailing Address - Phone:918-872-6515
Mailing Address - Fax:918-872-6516
Practice Address - Street 1:4716 W URBANA ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5997
Practice Address - Country:US
Practice Address - Phone:918-872-6515
Practice Address - Fax:918-872-6516
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0072815363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200560060 AMedicaid
OK200560060AMedicaid