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Individual

AMANDA LINDSEY TANAE HUNNICUTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
308 W MAIN ST STE 2, DURANT, OK 74701-5025
(580) 920-9053
(580) 920-9056
Mailing address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
(580) 298-6723

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
F7318643
OK

Other

Enumeration date
01/08/2019
Last updated
01/08/2019
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