Individual
AMBER BROOKE ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201
(318) 966-1373
Mailing address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 966-1373
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN141440
LA
363LF0000X
Family Nurse Practitioner
Primary
AP10177
LA
Other
Enumeration date
07/18/2018
Last updated
07/27/2018
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