Provider Demographics
NPI:1881416584
Name:HERRERA, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 PINEHURST BOULEVARD
Mailing Address - Street 2:APT 701
Mailing Address - City:WAVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45690-9682
Mailing Address - Country:US
Mailing Address - Phone:740-771-2956
Mailing Address - Fax:
Practice Address - Street 1:246 PINEHURST BOULEVARD
Practice Address - Street 2:APT 701
Practice Address - City:WAVERLY
Practice Address - State:OH
Practice Address - Zip Code:45690-9682
Practice Address - Country:US
Practice Address - Phone:740-771-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant