Provider Demographics
NPI:1497222467
Name:NAL, AMBER N
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:N
Last Name:NAL
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 1:45 LOGANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2537
Mailing Address - Country:US
Mailing Address - Phone:937-286-9044
Mailing Address - Fax:
Practice Address - Street 1:45 LOGANWOOD DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-2537
Practice Address - Country:US
Practice Address - Phone:937-286-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide