Provider Demographics
NPI:1265862320
Name:HART, SHEILA (PMHNP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10025 S 705 RD
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:OK
Mailing Address - Zip Code:74370-9507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10025 S 705 RD
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:OK
Practice Address - Zip Code:74370-9507
Practice Address - Country:US
Practice Address - Phone:918-303-5433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO096219363LP0808X
KS79405363LP0808X
OKR0051971363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health