Provider Demographics
NPI:1376270959
Name:KELLEY, AMBER N
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:N
Last Name:KELLEY
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 1:1320 PAULSON WAY
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-5127
Mailing Address - Country:US
Mailing Address - Phone:720-207-7616
Mailing Address - Fax:
Practice Address - Street 1:1916 PATTERSON ST STE 700
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2177
Practice Address - Country:US
Practice Address - Phone:615-593-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist