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General NPI Number Information
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NPI Number | 1710355896
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Entity Type | Organization
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Legal Business Name | AMBER THRASH CREEL FNP LLC
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Dates
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Enumeration Date | 09/08/2015
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Last Update Date | 09/08/2015
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Provider Practice Location Address
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Address Line | 26308 BUFORD CREEL RD
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City | FRANKLINTON
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State | LA
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Zip | 70438-6322
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Country | US
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Telephone | 985-839-6945
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Fax | 985-839-9379
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Provider Business Mailing Address
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Address Line | 26308 BUFORD CREEL RD
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City | FRANKLINTON
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State | LA
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Zip | 70438-6322
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Country | US
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Telephone | 985-839-6945
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Fax | 985-839-9379
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMBER NICOLE CREEL
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Credential | FNP
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Telephone | 985-839-6945
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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 | AP08499
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License Number State | LA
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