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General NPI Number Information
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NPI Number | 1184218604
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Entity Type | Individual
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Provider Name | KELLI AMANDA DOBBS APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 02/24/2021
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 13600 E 86TH ST N STE 100
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City | OWASSO
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State | OK
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Zip | 74055-8732
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Country | US
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Telephone | 918-272-9313
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Fax | 918-403-6311
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Provider Business Mailing Address
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Address Line | 1923 S UTICA AVE GROUND FL, MEDICAL STAFF OFC
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City | TULSA
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State | OK
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Zip | 74104-6520
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Country | US
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Telephone | 918-272-9313
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Fax | 918-403-6311
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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 | 201362
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License Number State | OK
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