Healthcare Provider Details

I. General information

NPI: 1457270548
Provider Name (Legal Business Name): AMBER GUNNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SEXTON WAY
MIDWAY KY
40347-7800
US

IV. Provider business mailing address

113 WISTERIA LN
FRANKFORT KY
40601-7828
US

V. Phone/Fax

Practice location:
  • Phone: 859-846-4663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1175587
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: