Healthcare Provider Details

I. General information

NPI: 1619647765
Provider Name (Legal Business Name): AMBER MARIE MILLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER KRAUSE

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3519 HIGHWAY 32
TEKAMAH NE
68061-5095
US

IV. Provider business mailing address

3519 HIGHWAY 32
TEKAMAH NE
68061-5095
US

V. Phone/Fax

Practice location:
  • Phone: 402-374-1585
  • Fax: 402-374-1612
Mailing address:
  • Phone: 402-374-1585
  • Fax: 402-374-1612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113786
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: