Healthcare Provider Details

I. General information

NPI: 1225940562
Provider Name (Legal Business Name): AMBER LEE BYER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 OSBORNE RD NE
FRIDLEY MN
55432-2718
US

IV. Provider business mailing address

16013 116TH AVE N
OSSEO MN
55369-7532
US

V. Phone/Fax

Practice location:
  • Phone: 512-569-8774
  • Fax:
Mailing address:
  • Phone: 512-569-8774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2520009
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: