Provider Demographics
NPI:1568358109
Name:ESPINOZA, AMBER (BSN, RN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 ROAD 16
Mailing Address - Street 2:
Mailing Address - City:OTTO
Mailing Address - State:WY
Mailing Address - Zip Code:82434-9713
Mailing Address - Country:US
Mailing Address - Phone:307-247-0806
Mailing Address - Fax:
Practice Address - Street 1:4433 ROAD 16
Practice Address - Street 2:
Practice Address - City:OTTO
Practice Address - State:WY
Practice Address - Zip Code:82434-9713
Practice Address - Country:US
Practice Address - Phone:307-247-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY37795163WM0705X, 163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscienceGroup - Multi-Specialty
No163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Multi-Specialty