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General NPI Number Information
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NPI Number | 1699630285
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Entity Type | Individual
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Provider Name | AMANDA WOOLMAN- CARNES PHD FUNCTIONAL MED
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Gender | Female
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 1733 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74104-5343
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Country | US
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Telephone | 970-470-0731
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Fax |
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Provider Business Mailing Address
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Address Line | 1733 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74104-5343
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Country | US
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Telephone |
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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 | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | NPCN-17616-15816
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License Number State |
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