Provider Demographics
NPI:1831883354
Name:CORDERO, AMBER (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:CORDERO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:CHRISTINE
Other - Last Name:TATUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5538 UPPER MONTAGUE RD
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:TX
Mailing Address - Zip Code:76230-7823
Mailing Address - Country:US
Mailing Address - Phone:940-235-8274
Mailing Address - Fax:
Practice Address - Street 1:800 W HIGHWAY 82
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2524
Practice Address - Country:US
Practice Address - Phone:940-301-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1124676363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily