Provider Demographics
NPI:1295295228
Name:NEUSER, AMBER LYNN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:NEUSER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5535 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-8400
Mailing Address - Country:US
Mailing Address - Phone:920-973-5158
Mailing Address - Fax:
Practice Address - Street 1:5535 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-8400
Practice Address - Country:US
Practice Address - Phone:920-973-5158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI316290-31164W00000X
WI261446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty