Basic Information
| Provider Information | |||||||||
| NPI: | 1083987754 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NIEGEL | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4896 PLEASANT GROVE RD | ||||||||
| Address2: | |||||||||
| City: | PLEASANT GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956689724 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307016321 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1965 LIVE OAK BLVD | ||||||||
| Address2: | |||||||||
| City: | YUBA CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 959918850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308227200 | ||||||||
| FaxNumber: | 5308227514 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2012 | ||||||||
| LastUpdateDate: | 02/10/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | 246599 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.