Provider Demographics
NPI:1679198691
Name:DENSON, AMBER MARLENA
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MARLENA
Last Name:DENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17191 COUNTY ROAD 1108
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:TX
Mailing Address - Zip Code:75762-2630
Mailing Address - Country:US
Mailing Address - Phone:903-373-3492
Mailing Address - Fax:
Practice Address - Street 1:17191 COUNTY ROAD 1108
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:TX
Practice Address - Zip Code:75762-2630
Practice Address - Country:US
Practice Address - Phone:903-373-3492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX806166163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty