Healthcare Provider Details

I. General information

NPI: 1689355273
Provider Name (Legal Business Name): AMBER DANYELE LINCICOME APRN, CPNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PLZ # 2
DAYTON OH
45404-1873
US

IV. Provider business mailing address

2900 N ROCKY POINT DR
TAMPA FL
33607-1460
US

V. Phone/Fax

Practice location:
  • Phone: 513-872-6000
  • Fax: 513-872-6025
Mailing address:
  • Phone: 614-722-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.003279
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: