Provider Demographics
NPI:1992225981
Name:HOLMAN, AMANDA (PHARM D)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 E 71ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2755
Mailing Address - Country:US
Mailing Address - Phone:918-492-3650
Mailing Address - Fax:918-495-2922
Practice Address - Street 1:6505 E 71ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-2755
Practice Address - Country:US
Practice Address - Phone:918-492-3650
Practice Address - Fax:918-495-2922
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15695183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist