Provider Demographics
NPI:1992392070
Name:GILBERT, AMBER JOANN (FNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:JOANN
Last Name:GILBERT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28755 SUGAR ISLAND CT
Mailing Address - Street 2:
Mailing Address - City:GIBRALTAR
Mailing Address - State:MI
Mailing Address - Zip Code:48173-9571
Mailing Address - Country:US
Mailing Address - Phone:734-301-3761
Mailing Address - Fax:
Practice Address - Street 1:2300 BIDDLE AVE
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4650
Practice Address - Country:US
Practice Address - Phone:734-246-5705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266399207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine