Individual
AMANDA R AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5224 E I 240 SERVICE RD FL 2, OKLAHOMA CITY, OK 73135-2607
(405) 608-3800
(405) 628-6791
Mailing address
7800 NW 85TH TER STE 200, OKLAHOMA CITY, OK 73132-3385
(405) 972-7239
(405) 753-1863
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
89429
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L100016517
DRIVER'S LICENSE
OK
Enumeration date
06/12/2017
Last updated
07/06/2017
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