Individual
ANITA M. AMBROSIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
120 WASHINGTON ST, KAUKAUNA, WI 54130
(920) 562-6018
Mailing address
2502 S ASHLAND AVE, GREEN BAY, WI 54304-5252
(920) 496-4700
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
125242-30
WI
363LF0000X
Family Nurse Practitioner
Primary
1938-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
439-53-700
—
WI
Enumeration date
04/03/2006
Last updated
10/13/2018
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