Provider Demographics
NPI:1225657786
Name:EDON, SHERRY GOODNIGHT (CRNA)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:GOODNIGHT
Last Name:EDON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:ANN
Other - Last Name:EDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 840848
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0848
Mailing Address - Country:US
Mailing Address - Phone:972-283-1999
Mailing Address - Fax:972-233-2666
Practice Address - Street 1:3300 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4418
Practice Address - Country:US
Practice Address - Phone:405-951-2815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33913367500000X
OKR0033913163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse