Individual
AMANDA SKVORTSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
109 W COMMERCIAL ST, BROKEN ARROW, OK 74012-4012
(918) 887-8300
Mailing address
31193 E 64TH ST S, BROKEN ARROW, OK 74014-8529
(941) 350-5179
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
221063
OK
Other
Enumeration date
11/27/2024
Last updated
12/02/2024
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