Provider Demographics
NPI:1053791616
Name:ADAMS, AMBER ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:ELIZABETH
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 DUOMO CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-1407
Mailing Address - Country:US
Mailing Address - Phone:901-201-0585
Mailing Address - Fax:
Practice Address - Street 1:6570 STAGE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-2839
Practice Address - Country:US
Practice Address - Phone:901-213-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000019856363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health