Alexis V Ambrose, L.P.N.

Individual provider Active NPI Licensed Practical Nurse · Tiffin, OH

NPI 1366733289 · NPPES record last updated Apr 26, 2011

Key facts

NPI
1366733289
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN. 122275 (OH)
Practice address
483 Autumnwood Dr
Apt. a
Tiffin, OH 44883-1870
Phone
(419) 618-7954
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN. 122275OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN. 122275 OH Yes

Addresses

Primary practice location

483 Autumnwood Dr
Apt. a
Tiffin, OH 44883-1870

Mailing address

483 Autumnwood Dr
Apt. a
Tiffin, OH 44883-1870
Phone (419) 618-7954

Other providers in Tiffin, OH

All providers in Tiffin, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.