Healthcare Provider Details

I. General information

NPI: 1487124210
Provider Name (Legal Business Name): AMANDA LAMBERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 12/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 SPRING HILL AVE
MOBILE AL
36607-1822
US

IV. Provider business mailing address

11312 CEIBA GRANDE ST
FAIRHOPE AL
36532-4681
US

V. Phone/Fax

Practice location:
  • Phone: 251-287-8420
  • Fax:
Mailing address:
  • Phone: 251-586-2486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number1-085396
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: