Healthcare Provider Details

I. General information

NPI: 1801727292
Provider Name (Legal Business Name): DR. AMANDA KRISTEN NEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S UTICA AVE
TULSA OK
74104-4090
US

IV. Provider business mailing address

18407 E 49TH PL
TULSA OK
74134-7315
US

V. Phone/Fax

Practice location:
  • Phone: 918-579-6695
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number15313
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: