Provider Demographics
NPI:1285204487
Name:KLIEWER, AMY SUE-YI
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:SUE-YI
Last Name:KLIEWER
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 1:9610 S INDIANAPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3920
Mailing Address - Country:US
Mailing Address - Phone:918-845-1374
Mailing Address - Fax:
Practice Address - Street 1:9610 S INDIANAPOLIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3920
Practice Address - Country:US
Practice Address - Phone:918-845-1374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program