Provider Demographics
NPI:1780111575
Name:KALABAT, AMBER SARAH (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:SARAH
Last Name:KALABAT
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:SARAH
Other - Last Name:ALKATIB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1844 POPPLETON DR
Mailing Address - Street 2:
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1152
Mailing Address - Country:US
Mailing Address - Phone:248-292-1571
Mailing Address - Fax:
Practice Address - Street 1:911 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220-1934
Practice Address - Country:US
Practice Address - Phone:248-336-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704293224363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily