Provider Demographics
NPI:1912300344
Name:MONTARELLA, AMBERLEE (NURSE PRACTITIONER F)
Entity Type:Individual
Prefix:
First Name:AMBERLEE
Middle Name:
Last Name:MONTARELLA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER F
Other - Prefix:
Other - First Name:AMBERLEE
Other - Middle Name:
Other - Last Name:LIVESEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER F
Mailing Address - Street 1:PO BOX 10748
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-0748
Mailing Address - Country:US
Mailing Address - Phone:661-431-1555
Mailing Address - Fax:661-633-3944
Practice Address - Street 1:8329 BRIMHALL ROAD
Practice Address - Street 2:SUITE 804
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312
Practice Address - Country:US
Practice Address - Phone:661-431-1555
Practice Address - Fax:661-633-3944
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily