Provider Demographics
NPI:1215661376
Name:MASON, AMY LYNN (APRN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:MASON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 ANTLER VLY
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-4443
Mailing Address - Country:US
Mailing Address - Phone:405-315-7591
Mailing Address - Fax:
Practice Address - Street 1:13100 N WESTERN AVE STE 303
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1432
Practice Address - Country:US
Practice Address - Phone:800-781-1220
Practice Address - Fax:866-678-8616
Is Sole Proprietor?:No
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK208259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily