Provider Demographics
NPI:1508578683
Name:PLATT, AMBER JEAN (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:JEAN
Last Name:PLATT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5580 JAVA LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ARCADE
Mailing Address - State:NY
Mailing Address - Zip Code:14009-9624
Mailing Address - Country:US
Mailing Address - Phone:716-462-3062
Mailing Address - Fax:
Practice Address - Street 1:12145 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:YORKSHIRE
Practice Address - State:NY
Practice Address - Zip Code:14173
Practice Address - Country:US
Practice Address - Phone:716-492-9300
Practice Address - Fax:716-492-9350
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY718138163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool