Provider Demographics
NPI:1851723985
Name:NAEGER, AMBER MARIE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:NAEGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:FARMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:59707 BARKLEY DR
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-9661
Mailing Address - Country:US
Mailing Address - Phone:248-921-2181
Mailing Address - Fax:
Practice Address - Street 1:16001 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-3137
Practice Address - Fax:248-849-2052
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-31
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601006721363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant