Provider Demographics
NPI:1295192375
Name:DICKERSON, AMBER (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:DICKERSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:SOSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:825 N GIBSON RD STE 311
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1708
Mailing Address - Country:US
Mailing Address - Phone:027-776-8300
Mailing Address - Fax:702-776-8303
Practice Address - Street 1:825 N GIBSON RD STE 311
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1708
Practice Address - Country:US
Practice Address - Phone:702-776-8300
Practice Address - Fax:702-776-8303
Is Sole Proprietor?:No
Enumeration Date:2016-01-21
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV830324363LA2200X
FLARNP 9337227363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care