Healthcare Provider Details

I. General information

NPI: 1245115419
Provider Name (Legal Business Name): AMBER LYNN MENDEZ APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 SE ADAMS RD
BARTLESVILLE OK
74006-8410
US

IV. Provider business mailing address

PO BOX 214
COLLINSVILLE OK
74021-0214
US

V. Phone/Fax

Practice location:
  • Phone: 918-331-9979
  • Fax:
Mailing address:
  • Phone: 918-261-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number225780
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: