Provider Demographics
NPI:1649763046
Name:MESSAMORE, AMBER R (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:MESSAMORE
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 N HIGHWAY 27 STE 7
Mailing Address - Street 2:
Mailing Address - City:SCIENCE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:42553-9140
Mailing Address - Country:US
Mailing Address - Phone:606-685-6131
Mailing Address - Fax:606-685-6179
Practice Address - Street 1:5775 N HIGHWAY 27 STE 7
Practice Address - Street 2:
Practice Address - City:SCIENCE HILL
Practice Address - State:KY
Practice Address - Zip Code:42553-9140
Practice Address - Country:US
Practice Address - Phone:606-685-6131
Practice Address - Fax:606-685-6179
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012399363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health