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Individual

JESSAMYN R AMBLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
705 RILEY HOSPITAL DR, SUITE 0860, INDIANAPOLIS, IN 46202-5109
(317) 944-8620
(317) 944-8080
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
71006594A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
063220021
MEDICARE
IN
05
201398460
IN
Enumeration date
10/04/2016
Last updated
01/03/2023
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