Provider Demographics
NPI:1598345738
Name:BALL, AMBER DAWN (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:DAWN
Last Name:BALL
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:N/A
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-4737
Mailing Address - Country:US
Mailing Address - Phone:606-753-0293
Mailing Address - Fax:606-753-0291
Practice Address - Street 1:268 ROLLING HILLS BLVD.
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-9004
Practice Address - Country:US
Practice Address - Phone:606-753-0293
Practice Address - Fax:606-753-0291
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3016010207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty