Provider Demographics
NPI:1861098212
Name:LAUER, AMBERLY REA JEAN (APRN)
Entity type:Individual
Prefix:
First Name:AMBERLY
Middle Name:REA JEAN
Last Name:LAUER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6909 BURLINGTON PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1618
Mailing Address - Country:US
Mailing Address - Phone:859-912-7716
Mailing Address - Fax:
Practice Address - Street 1:6909 BURLINGTON PIKE STE B
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1618
Practice Address - Country:US
Practice Address - Phone:859-912-7716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-10
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015446363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner