Provider Demographics
NPI:1912612805
Name:STIRE, AMBER MARIE (PMHNP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:STIRE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 CARLTON AVE UNIT Y55
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5719
Mailing Address - Country:US
Mailing Address - Phone:813-810-3020
Mailing Address - Fax:
Practice Address - Street 1:3500 CARLTON AVE UNIT Y55
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5719
Practice Address - Country:US
Practice Address - Phone:813-810-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0998376363LP0808X
CO1673770363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health