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General NPI Number Information
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NPI Number | 1609328509
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Entity Type | Individual
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Provider Name | COURTNEY ELIZABETH AMBROISE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/27/2016
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Last Update Date | 10/27/2016
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Provider Practice Location Address
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Address Line | 185 N LEWIS ST
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City | NEW IBERIA
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State | LA
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Zip | 70563-3925
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Country | US
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Telephone | 337-364-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 1013 BIG APPLE LANE
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City | SAINT MARTINVILLE
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State | LA
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Zip | 70582
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Country | US
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Telephone | 225-931-7482
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 021811
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License Number State | LA
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