Elder, Amanda Jean

Elder, Amanda Jean is an individual health care provider with primary practice located at 1705 E 19Th St Suite 302, Tulsa OK 74104-5405. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Elder, Amanda Jean can be contacted via phone (918) 748-7585.

Contact Information

Primary practice address
1705 E 19Th St Suite 302 Tulsa OK 74104-5405
Phone: (918) 748-7585
Fax: (918) 403-6352
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1429 Oklahoma

Profile Details

NPI number 1215900048
LBN Legal business name Elder, Amanda Jean
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 10th, 2006
Last updated Jul 22nd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215900048 NPPES
Oklahoma Other P00878501 MEDICARE RAILROAD
Oklahoma MEDICAID 200067560A MEDICARE RAILROAD

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