Healthcare Provider Details

I. General information

NPI: 1649935560
Provider Name (Legal Business Name): BAMF NURSING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2021
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14636 COTTONWOOD
EDMOND OK
73025-8568
US

IV. Provider business mailing address

14636 COTTONWOOD
EDMOND OK
73025-8568
US

V. Phone/Fax

Practice location:
  • Phone: 405-315-0141
  • Fax:
Mailing address:
  • Phone: 405-315-0141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL TODD ALLEN
Title or Position: OWNER
Credential: RN
Phone: 405-315-0141