Healthcare Provider Details

I. General information

NPI: 1700705027
Provider Name (Legal Business Name): AMBER L MOLTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER LIANA

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HARBOUR CT
KILL DEVIL HILLS NC
27948-9319
US

IV. Provider business mailing address

113 HARBOUR CT
KILL DEVIL HILLS NC
27948-9319
US

V. Phone/Fax

Practice location:
  • Phone: 252-305-0067
  • Fax:
Mailing address:
  • Phone: 252-305-0067
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06261654
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: