Provider Demographics
NPI:1114500980
Name:HUIATT, SHEILA RENEA (DPH)
Entity Type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:RENEA
Last Name:HUIATT
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245257 E 1000 RD
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-3271
Mailing Address - Country:US
Mailing Address - Phone:580-772-4214
Mailing Address - Fax:405-663-2480
Practice Address - Street 1:245257 E 1000 RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-3271
Practice Address - Country:US
Practice Address - Phone:580-772-4214
Practice Address - Fax:405-663-2480
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist