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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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ODOM, AMANDA KAYE       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: MERCY GOHEALTH URGENT CARE
1121 NW 63RD ST STE 5001
NICHOLS HILLS OK 73116

Address last updated on 10/6/2024
Phone #: (405) 652-0632
Fax #:
County: OKLAHOMA
License: 1017
Dated: 3/8/2000
Expires: 3/31/2025
Temp. Ltr. Issued: 12/23/1999
Temp. Ltr. Expires: 3/11/2000
License Type: Physician Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2025
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
MERCY GOHEALTH URGENT CARE
1121 NW 63RD ST STE 5001
NICHOLS HILLS OK 73116

Phone #: (405) 652-0632
Fax #:

Hospital Privileges:

None listed

Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
LARA DEL MASHEK MD 25902

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