Provider Demographics
NPI:1932358405
Name:HEMPHILL, AMBER LINN (PA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LINN
Last Name:HEMPHILL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 WESTOWN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1425
Mailing Address - Country:US
Mailing Address - Phone:515-991-6790
Mailing Address - Fax:515-401-1313
Practice Address - Street 1:2425 WESTOWN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1425
Practice Address - Country:US
Practice Address - Phone:515-991-6790
Practice Address - Fax:515-224-5140
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001921363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1932358405OtherBLUE CROSS BLUE SHIELD
IA1932358405Medicaid