Provider Demographics
NPI:1588168082
Name:RASMUSSEN, AMANDA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 W ROCK CREEK RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2461
Mailing Address - Country:US
Mailing Address - Phone:405-928-4229
Mailing Address - Fax:
Practice Address - Street 1:3321 W ROCK CREEK RD STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2461
Practice Address - Country:US
Practice Address - Phone:405-928-4229
Practice Address - Fax:405-573-5464
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK114170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily