Provider Demographics
NPI:1285179143
Name:SHARP, JEANNETTE ANN
Entity type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:ANN
Last Name:SHARP
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 1:40387 S COUNTY ROAD 4565
Mailing Address - Street 2:
Mailing Address - City:KEOTA
Mailing Address - State:OK
Mailing Address - Zip Code:74941-6447
Mailing Address - Country:US
Mailing Address - Phone:918-839-7380
Mailing Address - Fax:
Practice Address - Street 1:40387 S COUNTY ROAD 4565
Practice Address - Street 2:
Practice Address - City:KEOTA
Practice Address - State:OK
Practice Address - Zip Code:74941-6447
Practice Address - Country:US
Practice Address - Phone:918-839-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife