Healthcare Provider Details

I. General information

NPI: 1053743567
Provider Name (Legal Business Name): AMANDA J ISKEY APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA J REECE

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 EUNICE BURNS RD
EUFAULA OK
74432-4052
US

IV. Provider business mailing address

500 EUNICE BURNS RD
EUFAULA OK
74432-4052
US

V. Phone/Fax

Practice location:
  • Phone: 918-689-2547
  • Fax: 918-618-2167
Mailing address:
  • Phone: 918-689-2547
  • Fax: 918-618-2167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number90570
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: