Provider Demographics
NPI:1861201253
Name:CREMER, AMY MARIE (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:MARIE
Last Name:CREMER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 SILICON DR STE 102
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-7530
Mailing Address - Country:US
Mailing Address - Phone:682-300-9626
Mailing Address - Fax:
Practice Address - Street 1:558 SILICON DR STE 102
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7530
Practice Address - Country:US
Practice Address - Phone:682-300-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179594363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health