Healthcare Provider Details

I. General information

NPI: 1730552688
Provider Name (Legal Business Name): AMANDA QUARY APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2015
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105365 S HIGHWAY 102
MCLOUD OK
74851-3051
US

IV. Provider business mailing address

105365 S HIGHWAY 102
MCLOUD OK
74851-3051
US

V. Phone/Fax

Practice location:
  • Phone: 405-964-2081
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number82901
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number82901
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: