Provider Demographics
NPI:1194973727
Name:SWEETIN, MARY K (NP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:SWEETIN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:K
Other - Last Name:RICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 1992
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74502-1992
Mailing Address - Country:US
Mailing Address - Phone:918-426-2442
Mailing Address - Fax:
Practice Address - Street 1:200 S 3RD ST
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5420
Practice Address - Country:US
Practice Address - Phone:918-426-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0046408363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily