Amelia Roubideaux, APRN, AGNP-C
Nurse Practitioner, Primary Care in Oklahoma City, OK. Individual provider (NPI-1).
NPI number1669941894
StatusActive
Last updated in NPPESNov 16, 2018
Details
- NPI
- 1669941894
- Entity type
- Individual (NPI-1)
- Name
- Amelia Roubideaux
- Credential
- APRN, AGNP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 16, 2018
- Last updated
- Nov 16, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 109924 | OK | Yes |
Practice location
3613 Nw 56th St Ste 385Oklahoma City, OK 73112-4531
Phone 405-848-3555
Mailing address
1501 Sw 135th StOklahoma City, OK 73170-5125
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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