Individual
SUSAN AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4404 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5104
(425) 424-7711
Mailing address
2062 VAQUERO CT, EDMOND, OK 73034-2531
(405) 906-6572
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0098138
OK
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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