MEDICARE: MRS. AMBER LEIGH BOOTS CNP

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	NP10053	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.10053	OH

General Provider Information

NPI Number	:	1568643765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBER LEIGH BOOTS CNP

Provider Business Mailing Address
First Line	:	9775 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-1442
Country	:	US
Telephone Number	:	513-853-9700
Fax Number	:	513-853-8971

Provider Business Practice Location Address
First Line	:	9775 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-1442
Country	:	US
Telephone Number	:	513-853-9700
Fax Number	:	513-853-8971

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

Provider Enumeration Date	:	11/16/2007
Last Update Date	:	05/01/2023

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