Provider Demographics
NPI:1275960809
Name:MARTS, AMBER KAY (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:KAY
Last Name:MARTS
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1302 N OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-2356
Mailing Address - Country:US
Mailing Address - Phone:501-326-8513
Mailing Address - Fax:
Practice Address - Street 1:1302 N OLIVE ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-2356
Practice Address - Country:US
Practice Address - Phone:501-326-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR84035163W00000X
ARA004172363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse