Dr KATHLEEN D AMBROSE is a female medical professional, specializing in Nurse Practitioner. She graduated in 1995.
ST JOHN PROVIDENCE PHYSICIANS CMG
4260 VAN DYKE RD
SUITE 102
ALMONT
MI
480038546
Tel: 8107983994
| Npi | 1407816143 |
| Pac Id | 0749362671 |
| Professional Enrollment Id | I20080130000535 |
| Last Name | AMBROSE |
| First Name | KATHLEEN |
| Middle Name | D |
| Suffix | |
| Gender | F |
| Credential | |
| Medical School Name | OTHER |
| Graduation Year | 1995 |
| Primary Specialty | NURSE PRACTITIONER |
| Secondary Specialty 1 | |
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| Organization Legal Name | ST JOHN PROVIDENCE PHYSICIANS CMG |
| Group Practice Pac Id | 7517162761 |
| Number Of Group Practice Members | 62 |
| Line 1 Street Address | 4260 VAN DYKE RD |
| Line 2 Street Address | SUITE 102 |
| Marker Of Address Line 2 Suppression | |
| City | ALMONT |
| State | MI |
| Zip Code | 480038546 |
| Phone Number | 8107983994 |
| Hospital Affiliation Ccn 1 | 230165 |
| Hospital Affiliation Lbn 1 | ST JOHN HOSPITAL AND MEDICAL CENTER |
| Hospital Affiliation Ccn 2 | 230269 |
| Hospital Affiliation Lbn 2 | BEAUMONT HOSPITAL, TROY |
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| Hospital Affiliation Lbn 3 | |
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| Professional Accepts Medicare Assignment | Y |
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