Individual
AMBER GRACE FERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 792-2511
Mailing address
3515 BROADWAY AVE, GREAT BEND, KS 67530-3633
(620) 792-2511
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-79827-032
KS
Other
Enumeration date
01/28/2021
Last updated
06/22/2021
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