Provider Demographics
NPI:1275622458
Name:LOWRY, AMANDA (ARNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:LOWRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 MAGNOLIA CT STE 101
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-1433
Mailing Address - Country:US
Mailing Address - Phone:405-857-7681
Mailing Address - Fax:888-498-3708
Practice Address - Street 1:1201 MAGNOLIA CT STE 101
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-1433
Practice Address - Country:US
Practice Address - Phone:405-857-7681
Practice Address - Fax:888-498-3708
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0079704363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics