Provider Demographics
NPI:1992595425
Name:AMARO, EBONE (RN,CBC)
Entity type:Individual
Prefix:
First Name:EBONE
Middle Name:
Last Name:AMARO
Suffix:
Gender:X
Credentials:RN,CBC
Other - Prefix:
Other - First Name:EBONE
Other - Middle Name:
Other - Last Name:FORBES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,CBC
Mailing Address - Street 1:3910 N LAKE RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-5206
Mailing Address - Country:US
Mailing Address - Phone:448-200-8570
Mailing Address - Fax:
Practice Address - Street 1:3910 N LAKE RIDGE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-5206
Practice Address - Country:US
Practice Address - Phone:448-200-8570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9560179163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Multi-Specialty