Provider Demographics
NPI:1114785037
Name:FLAKES, AMBER NAKIA
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NAKIA
Last Name:FLAKES
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 1:1100 BOB COURTWAY DR STE 5
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4767
Mailing Address - Country:US
Mailing Address - Phone:501-908-0837
Mailing Address - Fax:
Practice Address - Street 1:1100 BOB COURTWAY DR STE 5
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4767
Practice Address - Country:US
Practice Address - Phone:501-908-0837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other