Provider Demographics
NPI:1639702996
Name:STANFILL, AMBERLY RENEE (MA, EKG TECH, BST)
Entity type:Individual
Prefix:MRS
First Name:AMBERLY
Middle Name:RENEE
Last Name:STANFILL
Suffix:
Gender:F
Credentials:MA, EKG TECH, BST
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:RENEE
Other - Last Name:STANFILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, EKG TECH
Mailing Address - Street 1:2235 E FLAMINGO RD STE 273
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0802
Mailing Address - Country:US
Mailing Address - Phone:725-204-7591
Mailing Address - Fax:702-920-8493
Practice Address - Street 1:2235 E FLAMINGO RD STE 273
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0802
Practice Address - Country:US
Practice Address - Phone:725-204-7591
Practice Address - Fax:702-920-8493
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1639702996OtherNPI