Healthcare Provider Details

I. General information

NPI: 1477952901
Provider Name (Legal Business Name): AMY ADAMS DNP, APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E FERRY ST
SALINA OK
74365-2988
US

IV. Provider business mailing address

11843 E APPLEHILL RD
PRAIRIE GROVE AR
72753-9301
US

V. Phone/Fax

Practice location:
  • Phone: 918-434-7440
  • Fax: 918-434-7441
Mailing address:
  • Phone: 251-656-5153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number214614
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: