Amber Renee Aylesworth, AGNP
Individual provider Active NPI Gerontology Nurse Practitioner · Pearl, MS
NPI 1780358192 · NPPES record last updated Aug 9, 2021
Key facts
- NPI
- 1780358192
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 2021036268. (MS)
- Practice address
- 3654 Hood Dr
Pearl, MS 39208-3805 - Phone
- (662) 571-8731
- NPI assigned
- Aug 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021036268. | MS | MD | Gerontology Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 2021036268. | MS | Yes |
Addresses
Primary practice location
3654 Hood Dr
Pearl, MS 39208-3805
Mailing address
3654 Hood Dr
Pearl, MS 39208-3805
Phone (662) 571-8731
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | phone | Direct |
Other providers in Pearl, MS
- Kassandra S Armstrong
- Patty Garlepied Arnold
- Assure Health and Wellness, LLC
- Richard J. Aubert Jr.
- Bimal Deep Aujla
- B1 Nursing Transport
- Baptist Physical Theraphy & Sportscare-Pearl
- Rechelle Carpenter Barber
- Santia Barfield
- Edgar D. Barham Jr.
All providers in Pearl, MS · Gerontology Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.