Provider Demographics
NPI:1376945857
Name:MEDLIN, SHEILA K
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:K
Last Name:MEDLIN
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 1:980547 S STAGECOACH
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:OKLAHOMA
Mailing Address - Zip Code:74881
Mailing Address - Country:UM
Mailing Address - Phone:405-820-6313
Mailing Address - Fax:
Practice Address - Street 1:980547 S STAGECOACH DR
Practice Address - Street 2:
Practice Address - City:WELLSTON
Practice Address - State:OK
Practice Address - Zip Code:74881-8225
Practice Address - Country:US
Practice Address - Phone:405-820-6313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator