Provider Demographics
NPI:1902028459
Name:NELSON, SHARYL LYNNE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHARYL
Middle Name:LYNNE
Last Name:NELSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:SHARYL
Other - Middle Name:DEASON
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:11175 COYOTE CIR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:OK
Mailing Address - Zip Code:73007-9203
Mailing Address - Country:US
Mailing Address - Phone:405-204-8314
Mailing Address - Fax:
Practice Address - Street 1:1501 NE 11TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-2605
Practice Address - Country:US
Practice Address - Phone:405-230-1134
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)