Individual
MRS. AMANDA DAWN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 421-4532
(580) 421-4572
Mailing address
7296 D 1376 RD, HOLDENVILLE, OK 74848-6008
(580) 272-3500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0074299
OK
Other
Enumeration date
10/02/2018
Last updated
11/14/2023
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