Provider Demographics
NPI:1952833972
Name:SHARP, JANNA NICHOLE
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:NICHOLE
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:NICHOLE
Other - Last Name:SPEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3929 SE 27TH ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-2619
Mailing Address - Country:US
Mailing Address - Phone:405-887-6215
Mailing Address - Fax:
Practice Address - Street 1:3929 SE 27TH ST
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-2619
Practice Address - Country:US
Practice Address - Phone:405-887-6215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator