Provider Demographics
NPI:1447022603
Name:MESSENGER, AMELIA ROSE
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:ROSE
Last Name:MESSENGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18236 BRIDLINGTON DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-5503
Mailing Address - Country:US
Mailing Address - Phone:405-388-1636
Mailing Address - Fax:
Practice Address - Street 1:2132 NE 36TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-5306
Practice Address - Country:US
Practice Address - Phone:405-388-1636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist