Provider Demographics
NPI:1477246361
Name:LAMBERT, AMANDA JEAN
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:JEAN
Last Name:LAMBERT
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 1:3609 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-9281
Mailing Address - Country:US
Mailing Address - Phone:440-812-1113
Mailing Address - Fax:
Practice Address - Street 1:3609 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-9281
Practice Address - Country:US
Practice Address - Phone:440-812-1113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033213364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health