Healthcare Provider Details

I. General information

NPI: 1912414830
Provider Name (Legal Business Name): AMY NICOLE SOMMER APRN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2017
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 E 141ST ST
GLENPOOL OK
74033-3583
US

IV. Provider business mailing address

PO BOX 103
KIEFER OK
74041-0103
US

V. Phone/Fax

Practice location:
  • Phone: 918-771-8771
  • Fax: 918-553-0356
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number109439
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: