Blease, Amber Brooke
Blease, Amber Brooke is an individual health care provider with primary practice located at 4 Live Oak Ct , Moultrie GA 31768. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Blease, Amber Brooke can be contacted via phone (229) 502-9788.Contact Information
Primary practice address
4 Live Oak Ct
Moultrie GA 31768
Phone: (229) 502-9788
Fax: (229) 890-2166
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN213604 | Georgia |
Profile Details
| NPI number | 1457758419 |
|---|---|
| LBN Legal business name | Blease, Amber Brooke |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 19th, 2014 |
| Last updated | Nov 4th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457758419 | NPPES |
| Georgia | Other | RN213604 | GA LICENSE |
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