Provider Demographics
NPI:1922801414
Name:STANISLAUS, AMBER LYNN
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:STANISLAUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 FREDERICK ST APT 5
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-3449
Mailing Address - Country:US
Mailing Address - Phone:402-813-4195
Mailing Address - Fax:
Practice Address - Street 1:3920 FREDERICK ST APT 5
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-3449
Practice Address - Country:US
Practice Address - Phone:402-813-4195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide