Basic Information
Provider Information
NPI: 1104392273
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: AMBER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 615 ELSINORE PL STE 200
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452021457
CountryCode: US
TelephoneNumber: 8335104357
FaxNumber: 8664602997
Practice Location
Address1: 1505 N COLE ST
Address2:  
City: LIMA
State: OH
PostalCode: 458012432
CountryCode: US
TelephoneNumber: 8335104357
FaxNumber: 8664602997
Other Information
ProviderEnumerationDate: 10/16/2018
LastUpdateDate: 12/03/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/03/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN.415852OHY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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