NPI 1659623627 · live from the CMS NPI Registry
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Clinic/Center, Primary Care in Ratliff City, OK. National Provider Identifier 1659623627, active.
NPI record
| NPI | 1659623627 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Primary Care 261QP2300X |
| Practice location | 1 Medical Plaza, Box 26, Ratliff City, OK 73481 |
| Practice phone | 580-856-2102 |
| Mailing address | Po Box 26, 1 Medical Plaza, Ratliff City, OK 73481 |
| Enumerated | October 15, 2012 |
| Last updated | October 31, 2012 |
| Authorized official | Amanda Recker, Sole Proprietor/Owner |
| Other names | Amanda Recker Aprn-Cnp |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Family | 363LF0000X | 85617 (OK) |
| Clinic/Center, Primary Care primary | 261QP2300X | 85617 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.