Provider Demographics
NPI:1538289087
Name:AMBUEHL, DENISE JOANNE
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:JOANNE
Last Name:AMBUEHL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DENISE
Other - Middle Name:JOANNE
Other - Last Name:ZUMBAHLEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 227
Mailing Address - Street 2:
Mailing Address - City:MULBERRY GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:62262-9305
Mailing Address - Country:US
Mailing Address - Phone:618-425-3770
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 227
Practice Address - Street 2:
Practice Address - City:MULBERRY GROVE
Practice Address - State:IL
Practice Address - Zip Code:62262-9305
Practice Address - Country:US
Practice Address - Phone:618-425-3770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist