Healthcare Provider Details

I. General information

NPI: 1144755786
Provider Name (Legal Business Name): AMBER BILLUPS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2017
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 10TH ST
SPENCER IA
51301-4307
US

IV. Provider business mailing address

101 E 10TH ST
SPENCER IA
51301-4307
US

V. Phone/Fax

Practice location:
  • Phone: 712-264-3500
  • Fax:
Mailing address:
  • Phone: 712-264-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12196
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-46575
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: