Provider Demographics
NPI:1023859220
Name:DEAN, AMBER (FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19686 CARPET BARN RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MO
Mailing Address - Zip Code:65338-2708
Mailing Address - Country:US
Mailing Address - Phone:573-378-8744
Mailing Address - Fax:
Practice Address - Street 1:3700 W 10TH ST STE 200
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-2540
Practice Address - Country:US
Practice Address - Phone:660-827-1771
Practice Address - Fax:660-827-1422
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024019264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily