Provider Demographics
NPI:1740064781
Name:HARRINGTON, AMBER (CPNP-PC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87A DEEP CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WIGGINS
Mailing Address - State:MS
Mailing Address - Zip Code:39577-9405
Mailing Address - Country:US
Mailing Address - Phone:601-528-0349
Mailing Address - Fax:
Practice Address - Street 1:2003 WILDWOOD DR
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-2178
Practice Address - Country:US
Practice Address - Phone:601-215-8060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS905895363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics