Basic Information
| Provider Information | |||||||||
| NPI: | 1457559833 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NALLEY | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 906 NORTH LEE STREET | ||||||||
| Address2: | |||||||||
| City: | STURGIS | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42459 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 509 NORTH CARRIER STREET | ||||||||
| Address2: | |||||||||
| City: | MORGANFIELD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 42437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2703893513 | ||||||||
| FaxNumber: | 2703894706 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | R3336 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.