Provider Demographics
NPI:1922746015
Name:JEWITT, SARAH ELISSE (APRN-CNP, PMHNP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ELISSE
Last Name:JEWITT
Suffix:
Gender:F
Credentials:APRN-CNP, PMHNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELISSE
Other - Last Name:GARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1008 24TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6369
Mailing Address - Country:US
Mailing Address - Phone:405-310-3262
Mailing Address - Fax:
Practice Address - Street 1:13301 N MERIDIAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8357
Practice Address - Country:US
Practice Address - Phone:405-310-3262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207985363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health