Healthcare Provider Details

I. General information

NPI: 1962986729
Provider Name (Legal Business Name): AMBER PRICE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER HOLT

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N 9TH AVE STE 307
PENSACOLA FL
32504-5719
US

IV. Provider business mailing address

4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US

V. Phone/Fax

Practice location:
  • Phone: 850-416-6378
  • Fax:
Mailing address:
  • Phone: 904-450-6014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: