Healthcare Provider Details

I. General information

NPI: 1851724488
Provider Name (Legal Business Name): AMBER ORELLANA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER LEE MATTSON FNP

II. Dates (important events)

Enumeration Date: 08/19/2013
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N MAIN ST STE 120
SPRINGBORO OH
45066-2100
US

IV. Provider business mailing address

5981 FAR HILLS AVE
DAYTON OH
45429-2211
US

V. Phone/Fax

Practice location:
  • Phone: 937-762-5030
  • Fax: 937-762-5039
Mailing address:
  • Phone: 937-428-6702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP5150
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.021249
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: