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Individual
MARY ANN AMBROSE
Active
Individual
MARY ANN AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN094333
AZ
363LF0000X
Family Nurse Practitioner
Primary
NP12654
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5854236
—
CA
01
—
P00011916
MEDICARE RAILROAD CARRIER
CA
Enumeration date
06/23/2005
Last updated
08/28/2012
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