Provider Demographics
NPI:1366163610
Name:CORE, AMBER NICOLE (RD)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:CORE
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-8800
Mailing Address - Fax:614-293-0495
Practice Address - Street 1:20325 N 51ST AVE STE 126
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5677
Practice Address - Country:US
Practice Address - Phone:602-341-5248
Practice Address - Fax:855-838-4958
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.09882133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered