Provider Demographics
NPI:1023861028
Name:AMBS, BETHANIE (CNM)
Entity type:Individual
Prefix:
First Name:BETHANIE
Middle Name:
Last Name:AMBS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 WELLNESS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48670-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4401 CAMPUS RIDGE DR
Practice Address - Street 2:STE LL0110
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6126
Practice Address - Country:US
Practice Address - Phone:989-837-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704284331367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife