Basic Information
Provider Information
NPI: 1518478007
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AUSTIN
FirstName: AMBER
MiddleName: YVONNE
NamePrefix: MRS.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SPRINGER
OtherFirstName: AMBER
OtherMiddleName:  
OtherNamePrefix: MISS
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 7527
Address2:  
City: DUBLIN
State: OH
PostalCode: 430170727
CountryCode: US
TelephoneNumber: 6145446155
FaxNumber: 6145446370
Practice Location
Address1: 1010 REFUGEE RD STE 310
Address2:  
City: PICKERINGTON
State: OH
PostalCode: 431479653
CountryCode: US
TelephoneNumber: 6145660774
FaxNumber: 6145330438
Other Information
ProviderEnumerationDate: 10/24/2017
LastUpdateDate: 01/25/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA059540PAN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000X50.006806RXOHY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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