Provider Demographics
NPI:1063095420
Name:BIDWELL, AMBER MORGAN (CLD)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:MORGAN
Last Name:BIDWELL
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:MORGAN
Other - Last Name:SUING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:798 NW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1519
Mailing Address - Country:US
Mailing Address - Phone:602-325-6253
Mailing Address - Fax:
Practice Address - Street 1:798 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1519
Practice Address - Country:US
Practice Address - Phone:602-325-6253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty