Provider Demographics
NPI:1073398335
Name:TRUMAN, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:TRUMAN
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 1:1392 RED BUD RD
Mailing Address - Street 2:
Mailing Address - City:OVAPA
Mailing Address - State:WV
Mailing Address - Zip Code:25164-7043
Mailing Address - Country:US
Mailing Address - Phone:304-618-7661
Mailing Address - Fax:
Practice Address - Street 1:980 IVYDALE RD
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:WV
Practice Address - Zip Code:25043-7011
Practice Address - Country:US
Practice Address - Phone:304-618-7661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker