Provider Demographics
NPI:1043321250
Name:SUGGS, SANDRA JOANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JOANNE
Last Name:SUGGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SUGGS RD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:OK
Mailing Address - Zip Code:74633
Mailing Address - Country:US
Mailing Address - Phone:580-765-4774
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE EAGLE DRIVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601
Practice Address - Country:US
Practice Address - Phone:580-765-2501
Practice Address - Fax:580-765-7289
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0031281163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse