Provider Demographics
NPI:1851522502
Name:CARRIVEAU, AMBER B (APNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:B
Last Name:CARRIVEAU
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:B
Other - Last Name:GEOCARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:4190 E WOODMEN RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-8075
Mailing Address - Country:US
Mailing Address - Phone:719-632-4455
Mailing Address - Fax:719-638-6891
Practice Address - Street 1:4190 E WOODMEN RD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8075
Practice Address - Country:US
Practice Address - Phone:719-632-4455
Practice Address - Fax:719-638-6891
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995174-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty