Healthcare Provider Details

I. General information

NPI: 1568829950
Provider Name (Legal Business Name): AMBER DESKINS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER BURKE

II. Dates (important events)

Enumeration Date: 01/15/2016
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4721 CHACE CIR
HOOVER AL
35244-3700
US

IV. Provider business mailing address

8592 DOVER DR
LEEDS AL
35094-7535
US

V. Phone/Fax

Practice location:
  • Phone: 205-823-0151
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-123766
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: