Provider Demographics
NPI:1649835315
Name:REPLOGLE, AMANDA R
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:R
Last Name:REPLOGLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 RENICK LN
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-5526
Mailing Address - Country:US
Mailing Address - Phone:814-591-8637
Mailing Address - Fax:
Practice Address - Street 1:4100 SE ADAMS RD STE E108
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-8409
Practice Address - Country:US
Practice Address - Phone:814-591-8637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator