Provider Demographics
NPI:1225650724
Name:PINNICK, AMBER MICHELLE
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MICHELLE
Last Name:PINNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 N HIWASSEE RD
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-7631
Mailing Address - Country:US
Mailing Address - Phone:405-615-3615
Mailing Address - Fax:
Practice Address - Street 1:833 N HIWASSEE RD
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-7631
Practice Address - Country:US
Practice Address - Phone:405-615-3615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator