Provider Demographics
NPI:1184398620
Name:FERRELL, AMY KATHLEEN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:KATHLEEN
Last Name:FERRELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 JUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2151
Mailing Address - Country:US
Mailing Address - Phone:405-924-1250
Mailing Address - Fax:
Practice Address - Street 1:929 JUSTIN DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-2151
Practice Address - Country:US
Practice Address - Phone:405-924-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-08
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201416363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily