Provider Demographics
NPI:1285295378
Name:ERLENBECK, AMBERLYN ROSE
Entity type:Individual
Prefix:
First Name:AMBERLYN
Middle Name:ROSE
Last Name:ERLENBECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 THREE MILE RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49544
Mailing Address - Country:US
Mailing Address - Phone:616-608-8933
Mailing Address - Fax:616-608-8934
Practice Address - Street 1:721 THREE MILE RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49544
Practice Address - Country:US
Practice Address - Phone:616-608-8933
Practice Address - Fax:616-608-8934
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant