Provider Demographics
NPI:1811558018
Name:STINNETT, AMBER HORLACHER (LM)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:HORLACHER
Last Name:STINNETT
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2028
Mailing Address - Country:US
Mailing Address - Phone:320-245-1040
Mailing Address - Fax:
Practice Address - Street 1:615 E 5TH ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2028
Practice Address - Country:US
Practice Address - Phone:320-245-1040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI260-49176B00000X
MN1075175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay
No176B00000XOther Service ProvidersMidwife