Provider Demographics
NPI:1134543580
Name:VAN VOORST, AMBER (RN, CRNA)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:VAN VOORST
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CRNA
Mailing Address - Street 1:3235 LINDEN LN
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-1221
Mailing Address - Country:US
Mailing Address - Phone:262-800-3183
Mailing Address - Fax:
Practice Address - Street 1:3801 SPRING ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53405-1667
Practice Address - Country:US
Practice Address - Phone:412-937-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-05
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR032445163W00000X
MNR181735-7163W00000X
WI100661367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse