Provider Demographics
NPI:1598532517
Name:BRESNAHAN, AMBER L (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:L
Last Name:BRESNAHAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MEDICAL CENTER BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3956
Mailing Address - Country:US
Mailing Address - Phone:610-447-8840
Mailing Address - Fax:610-447-8895
Practice Address - Street 1:30 MEDICAL CENTER BLVD STE 202
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3956
Practice Address - Country:US
Practice Address - Phone:610-447-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028786363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner