Healthcare Provider Details

I. General information

NPI: 1871083030
Provider Name (Legal Business Name): AMBER LYNN RILEY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS AMBER LYNN BAER

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 RICHARDSVILLE RD
BOWLING GREEN KY
42101-0429
US

IV. Provider business mailing address

PO BOX 1080
BURKESVILLE KY
42717-1080
US

V. Phone/Fax

Practice location:
  • Phone: 844-435-0900
  • Fax: 270-858-4029
Mailing address:
  • Phone: 270-858-6655
  • Fax: 270-858-4607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3012576
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: