Provider Demographics
NPI:1215540091
Name:AMBER DEAN DNP APRN PMHNP-BC LLC
Entity Type:Organization
Organization Name:AMBER DEAN DNP APRN PMHNP-BC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:308-672-1907
Mailing Address - Street 1:1011 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:NE
Mailing Address - Zip Code:69336-4057
Mailing Address - Country:US
Mailing Address - Phone:308-672-1907
Mailing Address - Fax:
Practice Address - Street 1:1011 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:NE
Practice Address - Zip Code:69336-4057
Practice Address - Country:US
Practice Address - Phone:308-672-1907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty