Provider Demographics
NPI:1609818368
Name:ADEMA, AMBER (CRNA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ADEMA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1778 S JASMINE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2127
Mailing Address - Country:US
Mailing Address - Phone:720-308-9083
Mailing Address - Fax:
Practice Address - Street 1:1778 S JASMINE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2127
Practice Address - Country:US
Practice Address - Phone:720-308-9083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700774367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC810466OtherC802022