Provider Demographics
NPI:1902698798
Name:SIDES, SHERRY (APRN FNP-C)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:SIDES
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54394 COUNTY ROAD 586
Mailing Address - Street 2:
Mailing Address - City:KANSAS
Mailing Address - State:OK
Mailing Address - Zip Code:74347-1321
Mailing Address - Country:US
Mailing Address - Phone:580-819-1899
Mailing Address - Fax:
Practice Address - Street 1:11011 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-2714
Practice Address - Country:US
Practice Address - Phone:918-878-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK222944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty