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NPI Code Detail

MEDICARE: AMANDA KELSEY BROWN

MEDICARE:   AMANDA KELSEY BROWN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramOK

General Provider Information

NPI Number : 1558292771
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA KELSEY BROWN
Provider Business Mailing Address
First Line : 3109 RAINTREE RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-1833
Country : US
Telephone Number : 405-708-9868
Fax Number :
Provider Business Practice Location Address
First Line : 3109 RAINTREE RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-1833
Country : US
Telephone Number : 405-708-9868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2026
Last Update Date : 05/27/2026

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Directions to “ AMANDA KELSEY BROWN ” Practice Location

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