Provider Demographics
NPI:1003181868
Name:NEALER, AMBERLY SUE (LPN)
Entity type:Individual
Prefix:
First Name:AMBERLY
Middle Name:SUE
Last Name:NEALER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:AMBERLY
Other - Middle Name:SUE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5801 E CABALLO DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-8111
Mailing Address - Country:US
Mailing Address - Phone:480-284-8884
Mailing Address - Fax:
Practice Address - Street 1:5801 E CABALLO DR
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-8111
Practice Address - Country:US
Practice Address - Phone:480-284-8884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLP046381164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse