MEDICARE: AMBER LYNN HESSELBROCK 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	APRN.CNP.024137	OH

General Provider Information

NPI Number	:	1538633896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LYNN HESSELBROCK APRN

Provider Business Mailing Address
First Line	:	1321 FUHRMAN RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-4003
Country	:	US
Telephone Number	:	513-888-8818
Fax Number	:

Provider Business Practice Location Address
First Line	:	2123 AUBURN AVE STE 404
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:	513-241-5630
Fax Number	:

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

Provider Enumeration Date	:	01/18/2019
Last Update Date	:	01/29/2019

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