Provider Demographics
NPI:1730911447
Name:LONG-KILMAN, AMBER ELIZABETH
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:ELIZABETH
Last Name:LONG-KILMAN
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 1:9408 SANTALA PL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3494
Mailing Address - Country:US
Mailing Address - Phone:505-470-3230
Mailing Address - Fax:
Practice Address - Street 1:9408 SANTALA PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3494
Practice Address - Country:US
Practice Address - Phone:505-470-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management