Provider Demographics
NPI:1427864453
Name:PARDO, AMBER (CHW)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PARDO
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:PARDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHW
Mailing Address - Street 1:711 ACADEMY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-4236
Mailing Address - Country:US
Mailing Address - Phone:219-286-2914
Mailing Address - Fax:
Practice Address - Street 1:711 ACADEMY ST APT 2
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-4236
Practice Address - Country:US
Practice Address - Phone:219-286-2914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty