Individual
AMBRIA REPASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
126 E MAIN PLZ, SAN ANTONIO, TX 78205-2745
(210) 223-2430
Mailing address
13900 LAKE SONG LN UNIT S4, BROOMFIELD, CO 80023-6555
(309) 945-8019
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APN.0993251
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APN.0993251
APN
CO
Enumeration date
08/17/2017
Last updated
08/17/2017
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