Provider Demographics
NPI:1366085813
Name:MCDOWELL, AMBER T (RN)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:T
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:SNEADS
Mailing Address - State:FL
Mailing Address - Zip Code:32460-0112
Mailing Address - Country:US
Mailing Address - Phone:850-263-5500
Mailing Address - Fax:850-263-1564
Practice Address - Street 1:5168 EZELL RD
Practice Address - Street 2:
Practice Address - City:GRACEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32440-2402
Practice Address - Country:US
Practice Address - Phone:850-263-5500
Practice Address - Fax:850-263-1564
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9316156163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN9316156OtherCORRECTIONAL FACILITY