Provider Demographics
NPI:1003697178
Name:O'HEARN, AMBER LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:O'HEARN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 CASTLETON DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-5111
Mailing Address - Country:US
Mailing Address - Phone:270-871-8016
Mailing Address - Fax:
Practice Address - Street 1:1815 CASTLETON DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-5111
Practice Address - Country:US
Practice Address - Phone:270-871-8016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-13
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4010678363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily