Individual
EVELYNE AMBROISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
111 EAGLES NEST DR, 0, HIRAM, GA 30141-3562
(770) 635-8173
(770) 635-8173
Mailing address
111 EAGLES NEST DR, 0, HIRAM, GA 30141-3562
(770) 635-8173
(770) 635-8173
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN074773
GA
Other
Enumeration date
02/05/2008
Last updated
02/05/2008
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