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1063238665
AMANDA SKVORTSOV
BROKEN ARROW, OK
NPI
1063238665
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: OK 221063)
Enumeration Date
2024-11-27
Last Update Date
2024-12-02
Business Address
AMANDA SKVORTSOV APRN
109 W COMMERCIAL ST
BROKEN ARROW, OK 74012-4012
Phone number: 918-887-8300
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Mailing Address
AMANDA SKVORTSOV APRN
31193 E 64TH ST S
BROKEN ARROW, OK 74014-8529
Phone number: 941-350-5179
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