Healthcare Provider Details

I. General information

NPI: 1760145924
Provider Name (Legal Business Name): AMBER NICHOLE NILES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7229 W OAKLAND PARK BLVD STE 101
LAUDERHILL FL
33313-1004
US

IV. Provider business mailing address

9505 NW 46TH ST
SUNRISE FL
33351-5109
US

V. Phone/Fax

Practice location:
  • Phone: 954-824-2616
  • Fax: 954-667-4007
Mailing address:
  • Phone: 954-629-5234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number86461
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2025050387
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11015990
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP001188
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1110846
License Number StateTX
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0040689
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number14264243-4405
License Number StateUT
# 8
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907966
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: