Provider Demographics
NPI:1205530664
Name:AMBROSE, BRITTANY MARIE (DO)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:AMBROSE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 PHAIRFIELD ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-9246
Mailing Address - Country:US
Mailing Address - Phone:661-201-8087
Mailing Address - Fax:
Practice Address - Street 1:600 GRESHAM DRIVE
Practice Address - Street 2:RALEIGH BUILDING, SUITE 304
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507
Practice Address - Country:US
Practice Address - Phone:757-388-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program