Healthcare Provider Details

I. General information

NPI: 1487195798
Provider Name (Legal Business Name): AMBER LYNN MOORE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMBER LYNN MILLER CRNP

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S GEORGE ST 4TH FLOOR
YORK PA
17403-3676
US

IV. Provider business mailing address

601 MEMORY LN
YORK PA
17402-2231
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-4005
  • Fax: 717-812-2495
Mailing address:
  • Phone: 717-851-1405
  • Fax: 717-851-6969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP016975
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP016975
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: