Provider Demographics
NPI:1760859896
Name:CREEL, AMBER THRASH (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:THRASH
Last Name:CREEL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-3688
Mailing Address - Country:US
Mailing Address - Phone:985-848-9955
Mailing Address - Fax:985-848-9964
Practice Address - Street 1:51704 HIGHWAY 438
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438-7488
Practice Address - Country:US
Practice Address - Phone:985-848-9955
Practice Address - Fax:985-848-9964
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08499363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2406591Medicaid
449524ZRA5Medicare UPIN