Provider Demographics
NPI:1417556499
Name:HOOGERHEYDE, AMBER BRITANY (LAT, ATC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:BRITANY
Last Name:HOOGERHEYDE
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:BRITANY
Other - Last Name:KREHBIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAT, ATC
Mailing Address - Street 1:11911 E 117TH ST N
Mailing Address - Street 2:
Mailing Address - City:VALLEY CENTER
Mailing Address - State:KS
Mailing Address - Zip Code:67147-8256
Mailing Address - Country:US
Mailing Address - Phone:620-960-0566
Mailing Address - Fax:
Practice Address - Street 1:600 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8780
Practice Address - Country:US
Practice Address - Phone:620-960-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-014872255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer