Provider Demographics
NPI:1851769863
Name:MARTINDALE, AMY L (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:MARTINDALE
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 1:4205 MCAULEY BLVD STE 375
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9309
Mailing Address - Country:US
Mailing Address - Phone:405-749-4247
Mailing Address - Fax:405-749-4249
Practice Address - Street 1:4205 MCAULEY BLVD STE 375
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9309
Practice Address - Country:US
Practice Address - Phone:405-350-4300
Practice Address - Fax:405-350-4302
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKR0069515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKR0069515OtherNURSING LICENSE