Provider Demographics
NPI:1548990161
Name:EVE, AMBER BRIANA
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:BRIANA
Last Name:EVE
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 1:4909 SHELBURNE ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-5605
Mailing Address - Country:US
Mailing Address - Phone:701-570-7592
Mailing Address - Fax:701-223-2843
Practice Address - Street 1:722 N MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:WATFORD CITY
Practice Address - State:ND
Practice Address - Zip Code:58854-7354
Practice Address - Country:US
Practice Address - Phone:701-705-7592
Practice Address - Fax:701-223-2843
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND171M00000X, 172A00000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172A00000XOther Service ProvidersDriver