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General NPI Number Information
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NPI Number | 1558193425
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Entity Type | Individual
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Provider Name | AMANDA PAYNE DNP, FNP-C, APRN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2024
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 5501 N PORTLAND AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2074
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Country | US
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Telephone | 405-949-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 SUNDOWN LN
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City | HARRAH
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State | OK
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Zip | 73045-8917
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Country | US
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Telephone | 405-650-5566
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 219244
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License Number State | OK
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