Provider Demographics
NPI:1720640204
Name:DEAN, AMBER JEWEL (DNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:JEWEL
Last Name:DEAN
Suffix:
Gender:F
Credentials:DNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DENVER AVE
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-9003
Mailing Address - Country:US
Mailing Address - Phone:308-672-1907
Mailing Address - Fax:
Practice Address - Street 1:2004 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-7858
Practice Address - Country:US
Practice Address - Phone:406-862-1030
Practice Address - Fax:406-862-1556
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-145700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health