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NPI Code Detail

MEDICARE: AMBER MARIE WORTH NP

MEDICARE: AMBER MARIE WORTH NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner4704277456MI

General Provider Information

NPI Number : 1467090076
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER MARIE WORTH NP
Provider Business Mailing Address
First Line : 102 W WASHINGTON ST STE 106
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-4350
Country : US
Telephone Number : 906-228-8881
Fax Number :
Provider Business Practice Location Address
First Line : 102 W WASHINGTON ST STE 106
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-4350
Country : US
Telephone Number : 906-228-8881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2019
Last Update Date : 05/02/2022

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