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General NPI Number Information
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NPI Number | 1952657587
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Entity Type | Individual
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Provider Name | AMANDA WYATT DNP, APRN-CNS,BC-ADM
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Gender | Female
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 7804 E 108TH ST STE A
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City | TULSA
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State | OK
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Zip | 74133-7423
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Country | US
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Telephone | 918-857-2135
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Fax |
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Provider Business Mailing Address
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Address Line | 8263 S HARVARD AVE # 715
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City | TULSA
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State | OK
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Zip | 74137-1614
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Country | US
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Telephone | 918-857-2135
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 99497
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | R0099497
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | R0099497
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | 2016019386
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License Number State | OK
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Taxonomy #5
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | R0099497
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License Number State | OK
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Taxonomy #6
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Taxonomy Code | 364SG0600X
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Taxonomy Name | Gerontology Clinical Nurse Specialist
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License Number | 2016019386
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License Number State | OK
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Taxonomy #7
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | 2016019386
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License Number State | OK
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