Provider Demographics
NPI:1144031659
Name:SWEAT, MYKINZY CHEYENNE (RPH)
Entity type:Individual
Prefix:
First Name:MYKINZY
Middle Name:CHEYENNE
Last Name:SWEAT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MYKINZY
Other - Middle Name:CHEYENNE
Other - Last Name:DIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:301 S BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:LUTHER
Mailing Address - State:OK
Mailing Address - Zip Code:73054-9172
Mailing Address - Country:US
Mailing Address - Phone:580-276-0499
Mailing Address - Fax:
Practice Address - Street 1:230 W WILSHIRE BLVD STE G3
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7749
Practice Address - Country:US
Practice Address - Phone:405-843-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK196931835P2201X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N0905XPharmacy Service ProvidersPharmacistNuclear
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care