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NPI Code Detail

MEDICARE: AMANDA LUCHA KENNEY APRN, WHNP-BC

MEDICARE: AMANDA LUCHA KENNEY APRN, WHNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse Practitioner207362OK
2163WX0003XInpatient Obstetric Registered NurseR0082970OK

General Provider Information

NPI Number : 1770235038
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LUCHA KENNEY APRN, WHNP-BC
Provider Business Mailing Address
First Line : 2004 PINE OAK DR
Second Line :
City : EDMOND
State : OK
Zip : 73013-5932
Country : US
Telephone Number : 405-206-8602
Fax Number :
Provider Business Practice Location Address
First Line : 6728 S HUDSON AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-7407
Country : US
Telephone Number : 405-419-4119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2022
Last Update Date : 05/26/2026

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