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NPI Code Detail

MEDICARE: AMBER GATES NP

MEDICARE:   AMBER  GATES  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 Practitioner0992003CO
2363LF0000XFamily Nurse PractitionerAPN.0992003-NPCO
3363LP0808XPsychiatric/Mental Health Nurse Practitioner0992003CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710357462
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER GATES NP
Provider Business Mailing Address
First Line : 4440 BARNES RD STE 245
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-1564
Country : US
Telephone Number : 719-600-9455
Fax Number :
Provider Business Practice Location Address
First Line : 4440 BARNES RD STE 245
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-1564
Country : US
Telephone Number : 719-600-9455
Fax Number : 719-466-9414
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2015
Last Update Date : 11/05/2024

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