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Individual

AMBER BROOKE BLEASE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
115 31ST AVE SE, MOULTRIE, GA 31768-6771
(229) 502-9788
(229) 890-2166
Mailing address
PO BOX 2876, MOULTRIE, GA 31776-2876
(229) 502-9788

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN213604
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN213604
GA LICENSE
GA
Enumeration date
11/19/2014
Last updated
09/08/2025
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