Individual
AMANDA HELM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
800 W BOISE CIR STE 250, BROKEN ARROW, OK 74012-4954
(918) 994-9250
(918) 403-6324
Mailing address
800 W BOISE CIR STE 250, BROKEN ARROW, OK 74012-4954
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2791
OK
363A00000X
Physician Assistant
9163864-8906
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200712080A
—
OK
Enumeration date
10/10/2014
Last updated
01/26/2021
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