Provider Demographics
NPI:1215597570
Name:FELTON, AMBER FAITH (IDMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:FAITH
Last Name:FELTON
Suffix:
Gender:F
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 19TH ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-4610
Mailing Address - Country:US
Mailing Address - Phone:661-477-6657
Mailing Address - Fax:
Practice Address - Street 1:148 19TH ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-4610
Practice Address - Country:US
Practice Address - Phone:661-477-6657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician