Provider Demographics
NPI:1255998068
Name:DILLS, AMBER (CNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DILLS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 MULL AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7522
Mailing Address - Country:US
Mailing Address - Phone:330-590-0847
Mailing Address - Fax:330-451-5782
Practice Address - Street 1:880 MULL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7522
Practice Address - Country:US
Practice Address - Phone:330-590-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAG05190051363LA2200X
OHAPRN.CNP.024758363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health