Provider Demographics
NPI:1891406401
Name:WHITLATCH, AMBER (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:WHITLATCH
Suffix:
Gender:
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7905 S STATE ROUTE 48
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8933
Mailing Address - Country:US
Mailing Address - Phone:213-722-3840
Mailing Address - Fax:513-296-6872
Practice Address - Street 1:7905 S STATE ROUTE 48
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8933
Practice Address - Country:US
Practice Address - Phone:213-722-3840
Practice Address - Fax:513-296-6872
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH509079163W00000X
OHAPRN.CNP.0033062363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse