Provider Demographics
NPI:1134443740
Name:AMBERGER, MELANIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:
Last Name:AMBERGER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5671 RIVERVIEW PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:THEODORE
Mailing Address - State:AL
Mailing Address - Zip Code:36582-5226
Mailing Address - Country:US
Mailing Address - Phone:251-443-5563
Mailing Address - Fax:
Practice Address - Street 1:6701 AIRPORT BLVD STE C132
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3784
Practice Address - Country:US
Practice Address - Phone:251-631-3501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073766363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily