Provider Demographics
NPI:1952829665
Name:AMBROSE, RACHEL BRITTANY (ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:BRITTANY
Last Name:AMBROSE
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8242 PINEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:KING GEORGE
Mailing Address - State:VA
Mailing Address - Zip Code:22485-7676
Mailing Address - Country:US
Mailing Address - Phone:540-907-0745
Mailing Address - Fax:
Practice Address - Street 1:8242 PINEWOOD LN
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-7676
Practice Address - Country:US
Practice Address - Phone:540-907-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-01
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175339363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care