Provider Demographics
NPI:1962800466
Name:SPARLIN, DAVID (APRN CNS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SPARLIN
Suffix:
Gender:M
Credentials:APRN CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-0308
Mailing Address - Country:US
Mailing Address - Phone:405-990-2995
Mailing Address - Fax:
Practice Address - Street 1:2328 EMILY LANE
Practice Address - Street 2:
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080-0308
Practice Address - Country:US
Practice Address - Phone:405-990-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101973364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist