Provider Demographics
NPI:1255188652
Name:MCINTIRE, AMBER ELIZABETH (FNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:ELIZABETH
Last Name:MCINTIRE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23325-3923
Mailing Address - Country:US
Mailing Address - Phone:717-521-2530
Mailing Address - Fax:
Practice Address - Street 1:351 EDWIN DR STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-4559
Practice Address - Country:US
Practice Address - Phone:757-499-5550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189192363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily