Provider Demographics
NPI:1497830046
Name:POPLIN, SARAH LYNN (CNM)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:POPLIN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:CRAIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNM
Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:918-488-6687
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:108 LONE OAK CIR
Practice Address - Street 2:
Practice Address - City:FORT GIBSON
Practice Address - State:OK
Practice Address - Zip Code:74434-5001
Practice Address - Country:US
Practice Address - Phone:918-478-6005
Practice Address - Fax:918-478-6020
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670042176B00000X
OKR57692367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200197400AMedicaid
TX1007007033Medicaid
TX1007007033Medicaid
TX87905HMedicare ID - Type Unspecified
OK731622831OtherEIN