Healthcare Provider Details

I. General information

NPI: 1205518289
Provider Name (Legal Business Name): KELSEY ALAYNE AMBLER WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELSEY GOSS RN

II. Dates (important events)

Enumeration Date: 08/01/2023
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 S ASPEN ST STOP 89
BUCKLEY AFB CO
80011-9562
US

IV. Provider business mailing address

275 S ASPEN ST STOP 89
BUCKLEY AFB CO
80011-9562
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-2273
  • Fax:
Mailing address:
  • Phone: 719-526-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPN.0998945-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: