Provider Demographics
NPI:1508443540
Name:GARRETT, AMBER (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 N COUNCIL AVE
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-8049
Mailing Address - Country:US
Mailing Address - Phone:405-597-2194
Mailing Address - Fax:
Practice Address - Street 1:5575 N COUNCIL AVE
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-8049
Practice Address - Country:US
Practice Address - Phone:405-597-2194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201676363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner