person
Nathan J Ambrose, PA
Surgical Physician Assistant in Lafayette, Louisiana
NPI 1326694076

Nathan J Ambrose is a Surgical Physician Assistant based in Lawrenceville, LA and is specialized in Surgical. Nathan J Ambrose practices in Lafayette, LA and has the professional credentials of PA. The NPI Number for Nathan J Ambrose is 1326694076 and holds a License No. (Louisiana).

The current practice location address for Nathan J Ambrose is 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA and can be reached out via phone at 337-470-3580 and via fax at 337-470-3586. You can also correspond with Nathan J Ambrose through the mailing address at 1132 GATHER DR, LAWRENCEVILLE, GA - 30043-7549 (mailing address contact number: 810-625-4218).

Location: 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA, 30043-7549
person
Provider Profile Details
NPI Number
1326694076
Provider Name
Nathan J Ambrose
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA, 30043-7549
Phone Number
337-470-3580
Fax Number
337-470-3586
Provider Enumeration Date
08/16/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
058924-PA 01 LA CDS
324792 01 LA STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
5000 Ambassador Caffery Pkwy Ste A
City
State
Zip
70508-6984
Phone Number
337-470-3580
Fax Number
337-470-3586
person
Provider Business Mailing Address Details
Address
5000 Ambassador Caffery Pkwy Ste A
City
State
Zip
70508-6984
Phone Number
337-470-3580
Fax Number
337-470-3586
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
324792 (Louisiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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