Provider Demographics
NPI:1336332162
Name:BROOKS, AMY LYNN (MS, ARNP, WHCNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MS, ARNP, WHCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9800 BROADWAY EXTENSION
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6304
Mailing Address - Country:US
Mailing Address - Phone:405-715-4496
Mailing Address - Fax:405-715-4499
Practice Address - Street 1:9800 BROADWAY EXTENSION
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6304
Practice Address - Country:US
Practice Address - Phone:405-715-4496
Practice Address - Fax:405-715-4499
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0073345363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKNONEOtherN/A