Provider Demographics
NPI:1154999076
Name:SHARP, MINDI LEE (RN)
Entity type:Individual
Prefix:
First Name:MINDI
Middle Name:LEE
Last Name:SHARP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MINDI
Other - Middle Name:LEE
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4400 N LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-5108
Mailing Address - Country:US
Mailing Address - Phone:580-225-5136
Mailing Address - Fax:
Practice Address - Street 1:4400 N LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-5108
Practice Address - Country:US
Practice Address - Phone:580-225-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator