Healthcare Provider Details

I. General information

NPI: 1366771313
Provider Name (Legal Business Name): AMBER MAURINE RAMSEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2009
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 MAR WALT DRIVE
FORT WALTON BEACH FL
32547
US

IV. Provider business mailing address

930 MAR WALT DRIVE
FORT WALTON FL
32547
US

V. Phone/Fax

Practice location:
  • Phone: 850-226-6801
  • Fax: 850-357-8400
Mailing address:
  • Phone: 850-226-6801
  • Fax: 850-357-8400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number0000012780
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18611
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number9441732
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0000012780
License Number StateTN
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number18611
License Number StateSC
# 6
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number9441732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: