Provider Demographics
NPI:1801348073
Name:WARLICK, AMBER ELIZABETH BANKS (FNP)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:ELIZABETH BANKS
Last Name:WARLICK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:ELIZABETH
Other - Last Name:BANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5311 N VANCOUVER AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-2731
Mailing Address - Country:US
Mailing Address - Phone:503-281-0308
Mailing Address - Fax:
Practice Address - Street 1:5311 N VANCOUVER AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217-2731
Practice Address - Country:US
Practice Address - Phone:503-281-0308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-03
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201609031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily