Provider Demographics
NPI:1255735940
Name:GOLDIZEN, AMBER LEE (NP)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LEE
Last Name:GOLDIZEN
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11875 S SUNSET DR STE 300
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-2794
Mailing Address - Country:US
Mailing Address - Phone:913-477-8308
Mailing Address - Fax:
Practice Address - Street 1:11875 S SUNSET DR STE 300
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-2794
Practice Address - Country:US
Practice Address - Phone:913-477-8308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN187456163W00000X
KS79562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse