Waters, Mandy Lynne

Waters, Mandy Lynne is an individual health care provider with primary practice located at 721 Better Now Plz , Ada OK 74820-2279. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Waters, Mandy Lynne can be contacted via phone (580) 272-0025.

Contact Information

Primary practice address
721 Better Now Plz Ada OK 74820-2279
Phone: (580) 272-0025
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R 0073536 Oklahoma

Profile Details

NPI number 1619327970
LBN Legal business name Waters, Mandy Lynne
Credentials APRN-CNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2016
Last updated Jan 11th, 2018 - 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 1619327970 NPPES
Oklahoma MEDICAID 550021ZHJP

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