Individual
JAYME AMBROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2017 E ADOBE ST, MESA, AZ 85213-6740
(480) 461-9370
Mailing address
2017 E ADOBE ST, MESA, AZ 85213-6740
(480) 461-9370
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN114415
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN114415
REGISTERED NURSE LICENSE
AZ
Enumeration date
05/10/2016
Last updated
05/10/2016
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