Provider Demographics
NPI:1144962770
Name:WHEELER, AMANDA SHAREE (BHCMII, CPRSS, BHWC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:SHAREE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:BHCMII, CPRSS, BHWC
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:SHAREE
Other - Last Name:CRASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:WELLING
Mailing Address - State:OK
Mailing Address - Zip Code:74471-0042
Mailing Address - Country:US
Mailing Address - Phone:918-207-8829
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 42
Practice Address - Street 2:
Practice Address - City:WELLING
Practice Address - State:OK
Practice Address - Zip Code:74471-0042
Practice Address - Country:US
Practice Address - Phone:918-207-8829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator