Provider Demographics
NPI:1942446042
Name:FEDERIZO, AMBER MARIE (DNP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARIE
Last Name:FEDERIZO
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:MS
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:VIERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:8352 W WARM SPRINGS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-3629
Mailing Address - Country:US
Mailing Address - Phone:702-330-0555
Mailing Address - Fax:702-832-1128
Practice Address - Street 1:8352 W WARM SPRINGS RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-3629
Practice Address - Country:US
Practice Address - Phone:702-330-0555
Practice Address - Fax:702-832-1128
Is Sole Proprietor?:No
Enumeration Date:2008-12-21
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV48717163W00000X
NVAPRN001334163WH0500X
NVAPN001334363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WH0500XNursing Service ProvidersRegistered NurseHemodialysis