Provider Demographics
NPI:1437448784
Name:ALLEN, AMBER B (NP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:B
Last Name:ALLEN
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Gender:F
Credentials:NP
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Mailing Address - Street 1:705 DALLAS HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-1247
Mailing Address - Country:US
Mailing Address - Phone:770-459-4411
Mailing Address - Fax:770-459-1897
Practice Address - Street 1:119 AMBULANCE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3857
Practice Address - Country:US
Practice Address - Phone:770-836-9658
Practice Address - Fax:770-838-8922
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
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Provider Licenses
StateLicense IDTaxonomies
GARN184309363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily