Provider Demographics
NPI:1164182937
Name:PUTSCHER, AMBER E
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:E
Last Name:PUTSCHER
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 1:128 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-4034
Mailing Address - Country:US
Mailing Address - Phone:214-491-2325
Mailing Address - Fax:
Practice Address - Street 1:3265 MILITARY RD
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:LA
Practice Address - Zip Code:71068-2809
Practice Address - Country:US
Practice Address - Phone:318-894-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX853137163W00000X
LA227544363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse