Provider Demographics
NPI:1811740350
Name:FOX MCNEIL, AMBER (CSW, RN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:FOX MCNEIL
Suffix:
Gender:F
Credentials:CSW, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 W 150 S
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:UT
Mailing Address - Zip Code:84737-2295
Mailing Address - Country:US
Mailing Address - Phone:603-249-6131
Mailing Address - Fax:
Practice Address - Street 1:48 S 2500 W
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:UT
Practice Address - Zip Code:84737-3375
Practice Address - Country:US
Practice Address - Phone:435-236-3177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13239706-3502101YP2500X
UT058854-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No163W00000XNursing Service ProvidersRegistered Nurse