Jacqueline Nicole Ambrus, RN, BSN

Individual provider Active NPI School Registered Nurse · Clovis, NM

NPI 1356114060 · NPPES record last updated Nov 3, 2023

Key facts

NPI
1356114060
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
RN-74021 (NM)
Practice address
1009 N Main St
Clovis, NM 88101-5932
Phone
(575) 769-4490
Fax
(575) 769-4430
NPI assigned
Nov 3, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN-74021NMMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Clovis Municipal Schools Past
since Nov 5, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN-74021 NM Yes

Addresses

Primary practice location

1009 N Main St
Clovis, NM 88101-5932

Mailing address

PO Box 19000
Clovis, NM 88102-9000
Phone (575) 769-4490

Other providers in Clovis, NM

All providers in Clovis, NM · School Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.