Individual
MRS. MARIA AMBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7900 W JEFFERSON BLVD STE 104, FORT WAYNE, IN 46804-4128
(260) 435-7350
Mailing address
11825 KEEPERS GATE, SPENCERVILLE, IN 46788-9289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007511A
IN
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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