Provider Demographics
NPI:1962966275
Name:BEDFORD, AMBERLY ROSE (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:AMBERLY
Middle Name:ROSE
Last Name:BEDFORD
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29075 SAN BERNARD RIVER LOOP
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4141
Mailing Address - Country:US
Mailing Address - Phone:281-515-2486
Mailing Address - Fax:
Practice Address - Street 1:29075 SAN BERNARD RIVER LOOP
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4141
Practice Address - Country:US
Practice Address - Phone:281-515-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140422363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care