Ambrose, Kathleen D

Ambrose, Kathleen D is an individual health care provider with primary practice located at 64580 Van Dyke Rd Suite C, Washington MI 48095-2857. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ambrose, Kathleen D can be contacted via phone (586) 752-9629.

Contact Information

Primary practice address
64580 Van Dyke Rd Suite C Washington MI 48095-2857
Phone: (586) 752-9629
Fax: (586) 752-4099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 470413564 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704131564 Michigan

Profile Details

NPI number 1407816143
LBN Legal business name Ambrose, Kathleen D
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Feb 1st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407816143 NPPES
Michigan Other 50-0866503-0 BCBS PIN NUMBER
Michigan MEDICAID 4378376 BCBS PIN NUMBER

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