Provider Demographics
NPI:1689439960
Name:MARTIN, AMBER DASHAI (MSN, APRN, AGACNP-BC)
Entity Type:Individual
Prefix:MS
First Name:AMBER
Middle Name:DASHAI
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 LEVERETTE RD APT 1703
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6631
Mailing Address - Country:US
Mailing Address - Phone:229-938-0638
Mailing Address - Fax:
Practice Address - Street 1:1485 LEVERETTE RD APT 1703
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6631
Practice Address - Country:US
Practice Address - Phone:229-938-0638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN281433363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner