Provider Demographics
NPI:1942974464
Name:STREET, AMBER KAY (DNP, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:KAY
Last Name:STREET
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 ARISTA DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6860
Mailing Address - Country:US
Mailing Address - Phone:469-757-8149
Mailing Address - Fax:888-927-0535
Practice Address - Street 1:1201 ARISTA DR STE 105
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6860
Practice Address - Country:US
Practice Address - Phone:469-757-8149
Practice Address - Fax:888-927-0535
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-07
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1049436OtherADVANCED PRACTICE REGISTERED NURSE - CNP