Provider Demographics
NPI:1083502843
Name:SUNSHINE CLINIC
Entity type:Organization
Organization Name:SUNSHINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-CNP
Authorized Official - Phone:918-443-7137
Mailing Address - Street 1:736 N LEWIS PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74110-5355
Mailing Address - Country:US
Mailing Address - Phone:918-443-7137
Mailing Address - Fax:918-306-8002
Practice Address - Street 1:1728 S CARSON AVE UNIT C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4610
Practice Address - Country:US
Practice Address - Phone:918-932-8266
Practice Address - Fax:918-306-8002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMAN LEGACY VENTURES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK201188580AMedicaid