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General NPI Number Information
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NPI Number | 1063930386
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Entity Type | Individual
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Provider Name | AMANDA LEIGH MAY CNP
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Gender | Female
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 09/07/2017
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Provider Practice Location Address
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Address Line | 859 E MELTON DR
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City | JAY
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State | OK
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Zip | 74346-2704
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Country | US
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Telephone | 918-253-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 58620 E 296 PL
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City | GROVE
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State | OK
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Zip | 74344-8021
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Country | US
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Telephone | 405-614-0988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R0087012
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License Number State | OK
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