MEDICARE: MRS. AMBER NICHOLE NILES 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	86461	NM
2	363LF0000X	Family Nurse Practitioner	2025050387	MO
3	363LF0000X	Family Nurse Practitioner	11015990	FL
4	363LF0000X	Family Nurse Practitioner	GAA-NP001188	GA
5	363LF0000X	Family Nurse Practitioner	1110846	TX
6	363LF0000X	Family Nurse Practitioner	APRN.CNP.0040689	OH
7	363LF0000X	Family Nurse Practitioner	14264243-4405	UT
8	363LF0000X	Family Nurse Practitioner	907966	MS

General Provider Information

NPI Number	:	1760145924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBER NICHOLE NILES APRN

Provider Business Mailing Address
First Line	:	9505 NW 46TH ST
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33351-5109
Country	:	US
Telephone Number	:	954-629-5234
Fax Number	:

Provider Business Practice Location Address
First Line	:	7229 W OAKLAND PARK BLVD STE 101
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-1004
Country	:	US
Telephone Number	:	954-824-2616
Fax Number	:	954-667-4007

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

Provider Enumeration Date	:	10/14/2021
Last Update Date	:	01/09/2026

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