Healthcare Provider Details

I. General information

NPI: 1376577932
Provider Name (Legal Business Name): YVONNE THERESA AMBROSE FNP-C, ACNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 N MAPLE
MUENSTER TX
76252
US

IV. Provider business mailing address

PO BOX 370
MUENSTER TX
76252-0370
US

V. Phone/Fax

Practice location:
  • Phone: 940-759-2226
  • Fax: 940-759-2385
Mailing address:
  • Phone: 940-759-2226
  • Fax: 940-759-2385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number231240
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: