Provider Demographics
NPI:1417483488
Name:DAMRAU, AMBER (RN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DAMRAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:DAMRAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:915 MEADOWLARK DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714-3313
Mailing Address - Country:US
Mailing Address - Phone:608-698-3758
Mailing Address - Fax:
Practice Address - Street 1:915 MEADOWLARK DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-3313
Practice Address - Country:US
Practice Address - Phone:608-698-3758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI158437-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse