Provider Demographics
NPI:1053743567
Name:ISKEY, AMANDA J (APRN-CNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:ISKEY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:J
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 EUNICE BURNS RD
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:OK
Mailing Address - Zip Code:74432-4052
Mailing Address - Country:US
Mailing Address - Phone:918-689-2547
Mailing Address - Fax:918-618-2167
Practice Address - Street 1:500 EUNICE BURNS RD
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:OK
Practice Address - Zip Code:74432-4052
Practice Address - Country:US
Practice Address - Phone:918-689-2547
Practice Address - Fax:918-618-2167
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK90570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200509790Medicaid