MEDICARE: AMBER WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1568310274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER WILSON

Provider Business Mailing Address
First Line	:	15 WOODPECKER LN
Second Line	:
City	:	MORIARTY
State	:	NM
Zip	:	87035-5392
Country	:	US
Telephone Number	:	505-226-1460
Fax Number	:	505-521-5191

Provider Business Practice Location Address
First Line	:	1209 US ROUTE 66 W STE C
Second Line	:
City	:	MORIARTY
State	:	NM
Zip	:	87035-1039
Country	:	US
Telephone Number	:	505-226-1566
Fax Number	:	505-521-5191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

Similar Medicare Providers

1922319938 — SHANNON MARIE BURKE LPCC
Practice Location Address:

1209 W US ROUTE 66 STE A
MORIARTY, NM
87035-1039

Practice Phone: 505-220-6971
Practice Fax: 505-832-4441

1578071999 — SARA LOMBARDI LPCC
Practice Location Address:

1209 W US ROUTE 66 STE A
MORIARTY, NM
87035-1039

Practice Phone: 505-303-9597
Practice Fax: 505-832-4441

1669455994 — FOWLER ENTERPRISES INC
Practice Location Address:

2005B US ROUTE 66 WEST
MORIARTY, NM
87035

Practice Phone: 505-832-4011
Practice Fax: 505-832-0434

1942269204 — DR. KIMBERLY A BIRCH DO
Practice Location Address:

1108 CENTRAL AVENUE
MORIARTY, NM
87035

Practice Phone: 505-832-4434
Practice Fax: 505-832-5024

1710944947 — TORRANCE COUNTY COUNSELING, LLC
Practice Location Address:

1701 US RT. 66 , SUITE D
MORIARTY, NM
87035

Practice Phone: 505-832-9135
Practice Fax: 505-832-9404

1972550184 — GREGORY J MARONEY PA-C
Practice Location Address:

1108 W US ROUTE 66
MORIARTY, NM
87035-1006

Practice Phone: 505-832-4434
Practice Fax: 505-832-5024

Directions to “ AMBER WILSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.