Provider Demographics
NPI:1942974464
Name:STREET, AMBER KAY (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:KAY
Last Name:STREET
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W RALPH HALL PKWY STE 237
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6661
Mailing Address - Country:US
Mailing Address - Phone:214-618-2044
Mailing Address - Fax:214-618-7838
Practice Address - Street 1:1005 W RALPH HALL PKWY
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6658
Practice Address - Country:US
Practice Address - Phone:214-618-2044
Practice Address - Fax:214-618-7838
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049436363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1049436OtherADVANCED PRACTICE REGISTERED NURSE - CNP