NPI 1013335546 · live from the CMS NPI Registry
Jacqueline Ebony Ambush, PNP BC
Nurse Practitioner, Pediatrics in Baltimore, MD. National Provider Identifier 1013335546, active.
NPI record
| NPI | 1013335546 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 4367 Hollins Ferry Rd, Ste.1c, Baltimore, MD 21227 |
| Practice phone | 410-707-5947 |
| Mailing address | 4367 Hollins Ferry Rd Ste 1c, Baltimore, MD 21227 |
| Enumerated | April 2, 2014 |
| Last updated | April 29, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Primary Care | 363LP2300X | R117755 (MD) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | R117755 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.