Provider Demographics
NPI:1508242678
Name:LAVIN, AMBER (DNP, CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:LAVIN
Suffix:
Gender:F
Credentials:DNP, CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SUNNYVIEW LN STE 101
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3128
Mailing Address - Country:US
Mailing Address - Phone:406-751-8009
Mailing Address - Fax:406-257-6463
Practice Address - Street 1:210 SUNNYVIEW LN STE 101
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3128
Practice Address - Country:US
Practice Address - Phone:406-751-8009
Practice Address - Fax:406-257-6463
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-RN-LIC-78174367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife