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General NPI Number Information
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NPI Number | 1295557114
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Entity Type | Individual
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Provider Name | AMBER NICOLE ROSE NP
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Gender | Female
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 04/08/2026
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Provider Practice Location Address
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Address Line | 1920 DONEGAL DR STE 200
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City | WOODBURY
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State | MN
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Zip | 55125-5804
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Country | US
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Telephone | 651-409-9229
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Fax |
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Provider Business Mailing Address
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Address Line | 11700 SAINT CROIX TRL N
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City | STILLWATER
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State | MN
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Zip | 55082-9582
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Country | US
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Telephone | 715-307-8246
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12251
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License Number State | MN
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