Basic Information
| Provider Information | |||||||||
| NPI: | 1568740454 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RYCHENER | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | |||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5700 MONROE ST | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | SYLVANIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435602767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194736622 | ||||||||
| FaxNumber: | 4194736627 | ||||||||
| Practice Location | |||||||||
| Address1: | 5700 MONROE ST | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | SYLVANIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435602767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194736622 | ||||||||
| FaxNumber: | 4194736627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2011 | ||||||||
| LastUpdateDate: | 10/17/2016 | ||||||||
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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 | 363LA2200X | RN341320-COA1 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 1568740454 | 01 | OH | NPI | OTHER | 0051258 | 05 | OH | MEDICAID |