Provider Demographics
NPI:1730073354
Name:PETERSON, AMBER LYNN (PMHNP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LYNN
Last Name:PETERSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12297 N MILLER CANYON CT
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-6726
Mailing Address - Country:US
Mailing Address - Phone:520-668-3477
Mailing Address - Fax:
Practice Address - Street 1:6501 E SANTA AURELIA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3127
Practice Address - Country:US
Practice Address - Phone:520-296-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ322960363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health