Provider Demographics
NPI:1275156622
Name:LOPEZ, AMBER LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 E FRANK PHILLIPS BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2406
Mailing Address - Country:US
Mailing Address - Phone:918-332-3600
Mailing Address - Fax:918-332-3613
Practice Address - Street 1:3460 E FRANK PHILLIPS BLVD
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2406
Practice Address - Country:US
Practice Address - Phone:918-332-3600
Practice Address - Fax:918-332-3613
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK106685363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology