Individual
DR. PATRICE MICHELLE AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 262-4160
Mailing address
302 DULLES DR, LAFAYETTE, LA 70506-3008
(337) 262-4100
(337) 262-4160
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD.09732R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09732R
MEDICAL LISCENSE
LA
05
—
1993778
—
LA
Enumeration date
02/23/2007
Last updated
01/12/2017
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