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General NPI Number Information
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NPI Number | 1275486144
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Entity Type | Individual
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Provider Name | BRIAN AMBROSE
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Gender | Male
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 3400 W 16TH ST
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City | GREELEY
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State | CO
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Zip | 80634-6862
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Country | US
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Telephone | 970-978-4386
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Fax |
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Provider Business Mailing Address
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Address Line | 7134 S YALE AVE STE 560
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City | TULSA
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State | OK
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Zip | 74136-6352
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN0337315
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License Number State | CO
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