Provider Demographics
NPI:1922746015
Name:JEWITT, SARAH ELISSE (APRN-CNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELISSE
Last Name:JEWITT
Suffix:
Gender:F
Credentials:APRN-CNP, PMHNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELISSE
Other - Last Name:GARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9228 S MINGO RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5718
Mailing Address - Country:US
Mailing Address - Phone:918-221-0877
Mailing Address - Fax:
Practice Address - Street 1:9228 S MINGO RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5718
Practice Address - Country:US
Practice Address - Phone:918-221-0877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207985363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health