Provider Demographics
NPI:1891071924
Name:SPARKS, LUCINDA LYNN (CNM)
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:LYNN
Last Name:SPARKS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1426 E BRADFORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-6884
Mailing Address - Country:US
Mailing Address - Phone:417-605-2153
Mailing Address - Fax:417-605-2153
Practice Address - Street 1:100 S BLISS AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-2512
Practice Address - Country:US
Practice Address - Phone:918-458-3100
Practice Address - Fax:918-458-3187
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX699258367A00000X
OK95371367A00000X
MO2022049695363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife