Provider Demographics
NPI:1134996028
Name:SUNRISE MENTAL HEALTH
Entity type:Organization
Organization Name:SUNRISE MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:APNP
Authorized Official - Phone:903-401-1663
Mailing Address - Street 1:2320 HOLLY LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-1510
Mailing Address - Country:US
Mailing Address - Phone:903-401-1663
Mailing Address - Fax:
Practice Address - Street 1:1322 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2016
Practice Address - Country:US
Practice Address - Phone:580-772-1623
Practice Address - Fax:580-203-3463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty