Provider Demographics
NPI:1285275594
Name:AMRINE, ASHLEY I (LPN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:I
Last Name:AMRINE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:I
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6100 S WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-7026
Mailing Address - Country:US
Mailing Address - Phone:405-634-4400
Mailing Address - Fax:
Practice Address - Street 1:6100 S WALKER AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-7026
Practice Address - Country:US
Practice Address - Phone:405-634-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-08
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK70519164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse