Healthcare Provider Details

I. General information

NPI: 1568940724
Provider Name (Legal Business Name): AMBER LILIA PELLINGTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 WATERS AVE
SAVANNAH GA
31404-6200
US

IV. Provider business mailing address

4750 WATERS AVE STE 452
SAVANNAH GA
31404-6235
US

V. Phone/Fax

Practice location:
  • Phone: 912-350-7412
  • Fax:
Mailing address:
  • Phone: 912-350-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1568940724
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: