Provider Demographics
NPI:1467935163
Name:RENFRO, AMY JO (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:RENFRO
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2210 DUNCAN REGIONAL LOOP
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1564
Mailing Address - Country:US
Mailing Address - Phone:580-251-6657
Mailing Address - Fax:580-251-8898
Practice Address - Street 1:731 12TH AVE NW STE 202
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5764
Practice Address - Country:US
Practice Address - Phone:580-220-6639
Practice Address - Fax:580-220-6640
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK103654363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily