Healthcare Provider Details

I. General information

NPI: 1396563086
Provider Name (Legal Business Name): AMBER ROBERTSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2024
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 PINE MARKET AVE BLDG 2
MONTGOMERY TX
77316-5022
US

IV. Provider business mailing address

13836 KOALSTAD RD
CONROE TX
77302-3504
US

V. Phone/Fax

Practice location:
  • Phone: 936-588-3514
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF09241238
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1192084
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: