Provider Demographics
NPI:1083081129
Name:AMBRIZ DE WILLIAMS, JUANA MARIA (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JUANA
Middle Name:MARIA
Last Name:AMBRIZ DE WILLIAMS
Suffix:
Gender:F
Credentials:DNP, FNP-BC
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Mailing Address - Street 1:2052 BLARNEY STONE DRIVE
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385
Mailing Address - Country:US
Mailing Address - Phone:877-880-7993
Mailing Address - Fax:877-880-7993
Practice Address - Street 1:2005 VALPARAISO ST STE 210
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3329
Practice Address - Country:US
Practice Address - Phone:219-841-6516
Practice Address - Fax:877-880-7993
Is Sole Proprietor?:No
Enumeration Date:2015-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28171474A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily