Provider Demographics
NPI:1134826233
Name:SHARP, ALLYSON DANIELLE
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:DANIELLE
Last Name:SHARP
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 1:7737 S MINGO RD APT 916
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3326
Mailing Address - Country:US
Mailing Address - Phone:918-771-8491
Mailing Address - Fax:
Practice Address - Street 1:19320 E ADMIRAL PL STE B
Practice Address - Street 2:
Practice Address - City:CATOOSA
Practice Address - State:OK
Practice Address - Zip Code:74015-3240
Practice Address - Country:US
Practice Address - Phone:918-340-5503
Practice Address - Fax:918-340-5505
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator