Provider Demographics
NPI:1477952901
Name:ADAMS, AMY (DNP, APRN, CNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:DNP, APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11843 E APPLEHILL RD
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE GROVE
Mailing Address - State:AR
Mailing Address - Zip Code:72753-9301
Mailing Address - Country:US
Mailing Address - Phone:251-656-5153
Mailing Address - Fax:
Practice Address - Street 1:101 E FERRY ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:OK
Practice Address - Zip Code:74365-2988
Practice Address - Country:US
Practice Address - Phone:918-434-7440
Practice Address - Fax:918-434-7441
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK214614363LF0000X
AL1-106959363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily