Provider Demographics
NPI:1942948575
Name:SHARRAR CHANDLER, SHAWNA MARIE
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:MARIE
Last Name:SHARRAR CHANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 NW 183RD CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-0649
Mailing Address - Country:US
Mailing Address - Phone:405-436-8384
Mailing Address - Fax:
Practice Address - Street 1:2109 NW 183RD CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-0649
Practice Address - Country:US
Practice Address - Phone:405-436-8384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist