Provider Demographics
NPI:1609537406
Name:NIPPER, AMBER M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:M
Last Name:NIPPER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8909 N 121ST EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2026
Mailing Address - Country:US
Mailing Address - Phone:918-629-7600
Mailing Address - Fax:
Practice Address - Street 1:7146 S BRADEN AVE STE 700
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6335
Practice Address - Country:US
Practice Address - Phone:918-878-8072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1427103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical