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: 08/01/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20370 E POWERS PL
CENTENNIAL CO
80015-3670
US

IV. Provider business mailing address

20370 E POWERS PL
CENTENNIAL CO
80015-3670
US

V. Phone/Fax

Practice location:
  • Phone: 720-255-4149
  • Fax:
Mailing address:
  • Phone: 720-255-4149
  • 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: