Healthcare Provider Details

I. General information

NPI: 1427685023
Provider Name (Legal Business Name): AMBER NICHOLE WALDROUP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BILTMORE AVE
ASHEVILLE NC
28801-4601
US

IV. Provider business mailing address

110 ROBERTS LAKE CIR APT 107
ARDEN NC
28704-0469
US

V. Phone/Fax

Practice location:
  • Phone: 828-775-1795
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number131447
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6364
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: