Provider Demographics
NPI:1750878039
Name:WOOD, AMBER NICHOLE (MD)
Entity type:Individual
Prefix:DR
First Name:AMBER
Middle Name:NICHOLE
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:NICHOLE
Other - Last Name:USRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5200 COMMERCE CROSSING
Mailing Address - Street 2:THRID FLOOR
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229
Mailing Address - Country:US
Mailing Address - Phone:502-253-4924
Mailing Address - Fax:502-489-5750
Practice Address - Street 1:2530 SIR BARTON WAY STE 125
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2746
Practice Address - Country:US
Practice Address - Phone:718-859-6390
Practice Address - Fax:859-639-0051
Is Sole Proprietor?:No
Enumeration Date:2018-04-22
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY558242084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100856920Medicaid