Provider Demographics
NPI:1699860601
Name:LAMPE, RUTH LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:LYNN
Last Name:LAMPE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:LYNN
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:900 E HARTFORD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-2011
Mailing Address - Country:US
Mailing Address - Phone:580-762-1911
Mailing Address - Fax:580-762-0887
Practice Address - Street 1:900 E HARTFORD AVE
Practice Address - Street 2:SUITE C
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2011
Practice Address - Country:US
Practice Address - Phone:580-762-1911
Practice Address - Fax:580-762-0887
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKD6093646363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKP00106188OtherRAILROAD MEDICARE
OK200016380AMedicaid
OKP95924Medicare UPIN
OK200016380AMedicaid