Provider Demographics
NPI:1508511528
Name:BRASSFIELD, AMBER MICHELLE (RN)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:MICHELLE
Last Name:BRASSFIELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 FALCONFIRE WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-4642
Mailing Address - Country:US
Mailing Address - Phone:619-254-4731
Mailing Address - Fax:
Practice Address - Street 1:352 FALCONFIRE WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-4642
Practice Address - Country:US
Practice Address - Phone:619-254-4731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-17
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA799672163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management