1902058050 NPI number — MRS. AMBER LEIGH MORROW ARNP

Table of content: MRS. AMBER LEIGH MORROW ARNP (NPI 1902058050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902058050 NPI number — MRS. AMBER LEIGH MORROW ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORROW
Provider First Name:
AMBER
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOXLEY
Provider Other First Name:
AMBER
Provider Other Middle Name:
LEIGH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1902058050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 785
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAWTON
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73502-0785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-357-9984
Provider Business Mailing Address Fax Number:
580-357-3277

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4411 W GORE BLVD
Provider Second Line Business Practice Location Address:
SUITE A2
Provider Business Practice Location Address City Name:
LAWTON
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73505-6016
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-355-0575
Provider Business Practice Location Address Fax Number:
580-248-1725
Provider Enumeration Date:
10/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  73704 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 73704 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 73704 . This is a "OKLAHOMA BOARD OF NURSING" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".




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