Provider Demographics
NPI:1891035697
Name:VEACH, AMBER (LPN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:VEACH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:FRAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4845 S. SHERIDAN RD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5719
Mailing Address - Country:US
Mailing Address - Phone:918-384-0002
Mailing Address - Fax:918-384-0004
Practice Address - Street 1:4845 S. SHERIDAN RD
Practice Address - Street 2:SUITE 510
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5719
Practice Address - Country:US
Practice Address - Phone:918-384-0002
Practice Address - Fax:918-384-0004
Is Sole Proprietor?:No
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0060333164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse