Individual
MRS. REBECCA CARROS AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1279 HIGHWAY 54 W STE 100, FAYETTEVILLE, GA 30214-4551
(770) 719-5710
Mailing address
702 CANTON ROAD, MARIETTA, GA 30060
(770) 428-4486
(770) 425-6008
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN112110
GA
367A00000X
Advanced Practice Midwife
Primary
RN112110
GA
Other
Enumeration date
08/22/2007
Last updated
11/18/2022
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