Healthcare Provider Details

I. General information

NPI: 1033732763
Provider Name (Legal Business Name): AMBER NICOLE DORROUGH MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 GLACIER HWY STE 104
JUNEAU AK
99801-8079
US

IV. Provider business mailing address

8800 GLACIER HWY STE 104
JUNEAU AK
99801-8079
US

V. Phone/Fax

Practice location:
  • Phone: 907-419-0650
  • Fax: 907-364-0708
Mailing address:
  • Phone: 907-419-0650
  • Fax: 907-364-0708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61186594
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number162977
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number168406
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN61186589
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: