Provider Demographics
NPI:1366078149
Name:TAYLOR, AMBER DELL (CRNA)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DELL
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:D
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5774 YELLOWDOG RD
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-6893
Mailing Address - Country:US
Mailing Address - Phone:662-292-0940
Mailing Address - Fax:
Practice Address - Street 1:6019 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2113
Practice Address - Country:US
Practice Address - Phone:901-226-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS889993163W00000X
TN131395367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse