Provider Demographics
NPI:1649891763
Name:SHEETS, EVAN (APRN)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:SHEETS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7396 E 125TH PL S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2650
Mailing Address - Country:US
Mailing Address - Phone:918-740-4490
Mailing Address - Fax:
Practice Address - Street 1:7396 E 125TH PL S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-2650
Practice Address - Country:US
Practice Address - Phone:918-740-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK121651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily