Provider Demographics
NPI:1205518289
Name:AMBLER, KELSEY ALAYNE (WHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:ALAYNE
Last Name:AMBLER
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:MISS
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:GOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:20370 E POWERS PL
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3670
Mailing Address - Country:US
Mailing Address - Phone:720-255-4149
Mailing Address - Fax:
Practice Address - Street 1:20370 E POWERS PL
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3670
Practice Address - Country:US
Practice Address - Phone:720-255-4149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998945-NP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health