MEDICARE: AMBER JAINIA WOOD APRN

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
1	363LF0000X	Family Nurse Practitioner	3010609	KY

General Provider Information

NPI Number	:	1538616578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER JAINIA WOOD APRN

Provider Business Mailing Address
First Line	:	467 JASPER LN
Second Line	:
City	:	MT WASHINGTON
State	:	KY
Zip	:	40047-6144
Country	:	US
Telephone Number	:	502-572-8769
Fax Number	:

Provider Business Practice Location Address
First Line	:	467 JASPER LN
Second Line	:
City	:	MT WASHINGTON
State	:	KY
Zip	:	40047-6144
Country	:	US
Telephone Number	:	502-572-8769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2016
Last Update Date	:	03/19/2025

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