Active NPI
Amanda Marie Wilson, LPN
- Licensed Practical Nurse
- Oklahoma City, OK
National Provider Identifier
1023976461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- L0057189
- Practice address
- 4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618 - Phone
- (405) 676-8470
- Fax
- (405) 676-5802
- NPI assigned
- Jan 14, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L0057189 | OK | Primary |
Addresses
Primary practice location
4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618
Mailing address
4013 NW Expressway Ste 105
Oklahoma City, OK 73116-2618
Phone (405) 676-8470
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L0057189 | OK | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1768348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1768348800000",
"number": "1023976461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4013 NW EXPRESSWAY STE 105",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731162618",
"telephone_number": "405-676-8470",
"fax_number": "405-676-5802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4013 NW EXPRESSWAY STE 105",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731162618",
"telephone_number": "405-676-8470",
"fax_number": "405-676-5802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "AMANDA",
"middle_name": "MARIE",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-01-14",
"last_updated": "2026-01-14",
"certification_date": "2026-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OK",
"license": "L0057189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.