Individual
SARAH MANSUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
221 W COMMERCIAL ST, BROKEN ARROW, OK 74012-4014
(918) 876-7483
Mailing address
221 W COMMERCIAL ST, BROKEN ARROW, OK 74012-4014
(918) 876-7483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0126289
OK
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
0126289
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0126289
RN LICENSE
OK
Enumeration date
01/17/2023
Last updated
01/17/2023
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