Provider Demographics
NPI:1427385376
Name:THORNE, AMBER NICOLE (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:THORNE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5044
Mailing Address - Country:US
Mailing Address - Phone:573-545-3700
Mailing Address - Fax:
Practice Address - Street 1:6468 STATE HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:MO
Practice Address - Zip Code:63736-8237
Practice Address - Country:US
Practice Address - Phone:573-545-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-13
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009034585363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner