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Individual
JACQUELINE EBONY AMBUSH
Active
Individual
JACQUELINE EBONY AMBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP BC
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R117755
MD
363LP2300X
Primary Care Nurse Practitioner
R117755
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R117755
MARYLAND BOARD OF NURSING
MD
Enumeration date
04/02/2014
Last updated
04/29/2026
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