Provider Demographics
NPI:1194910075
Name:EDWARDS, AMBER RAE (FNP-C, APRN)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:RAE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP-C, APRN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:RAE
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN RN
Mailing Address - Street 1:PO BOX 4484
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59702-4484
Mailing Address - Country:US
Mailing Address - Phone:406-565-2454
Mailing Address - Fax:406-593-1653
Practice Address - Street 1:2000 OTTAWA ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-6008
Practice Address - Country:US
Practice Address - Phone:406-565-2454
Practice Address - Fax:406-578-1542
Is Sole Proprietor?:No
Enumeration Date:2007-09-13
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT24455363LP0808X, 363LP2300X
MT100348363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care