| Organization Name: | NAN L. AMBROSY, ARNP, PA |
| NPI Number: | 1053522441 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP DOUGLAS HENDERSON (OFFICE MANAGER) |
| Mailing Address: | 1213 Hylton Heights Rd Suite 125 Manhattan |
| State: | KS US |
| Postal Code: | 665022810 |
| Phone Number: | 7855399990 |
| Fax Number: | 7855399998 |
| NPI Enumeration Date: | 05/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 74864 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |