Provider Demographics
NPI:1275608887
Name:CALDWELL, SHEREE L (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:SHEREE
Middle Name:L
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1128 N 438
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-2916
Mailing Address - Country:US
Mailing Address - Phone:918-606-5303
Mailing Address - Fax:
Practice Address - Street 1:111 NE 1ST ST
Practice Address - Street 2:
Practice Address - City:PRYOR
Practice Address - State:OK
Practice Address - Zip Code:74361-2403
Practice Address - Country:US
Practice Address - Phone:918-825-4224
Practice Address - Fax:918-825-3817
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0052253363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200115960AMedicaid