Provider Demographics
NPI:1033414321
Name:TIBERIO, AMBER (CRNA)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:TIBERIO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:STROUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15600 ALHAMBRA ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66224-8734
Mailing Address - Country:US
Mailing Address - Phone:913-808-0956
Mailing Address - Fax:
Practice Address - Street 1:6302 MONROVIA ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-2740
Practice Address - Country:US
Practice Address - Phone:913-341-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS557002367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered