Jacqueline Ebony Ambush
PNP BC | Nurse Practitioner - Primary Care
4367 Hollins Ferry Rd, Ste.1c, Baltimore
Maryland, 21227-3400
410-707-5947
Jacqueline Ebony Ambush is a Baltimore, Maryland based nurse practitioner who is specialized as Primary Care NP. Active license number of Jacqueline Ebony Ambush is R117755 for Pediatrics NP in Maryland. Her current practice location is 4367 Hollins Ferry Rd, Ste.1c, Baltimore. Patients can reach her at 410-707-5947. Jacqueline Ebony Ambush is PNP BC with specialization in Primary Care NP and her NPI number (Unique professional ID assigned by NPPES) is 1013335546.
Jacqueline Ebony Ambush is educated, certified and licensed to provide comprehensive, chronic, continuous care characterized by a long-term relationship with the patient. Primary Care Nurse Practitioners (PCNPs) screen, diagnose, and treat common acute and chronic medical diseases and conditions. They are also involved in health promotion, screening, and educating about primary prevention.
Complete Profile:
Jacqueline Ebony Ambush speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Jacqueline Ebony Ambush |
| Specialization: | Nurse Practitioner - Primary Care (PCNP) |
| Gender: | Female |
| Credentials: | PNP BC |
| Practice Address: | 4367 Hollins Ferry Rd, Ste.1c, Baltimore,
Maryland, 21227-3400 |
| Phone: | 410-707-5947 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1013335546 |
| NPI Enumeration Date: | 02 Apr, 2014 |
| NPI Last Update On: | 29 Apr, 2026 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jacqueline Ebony Ambush are as mentioned below.
| License Number | Specialization | State | Status | |
| R117755 | Pediatrics NP | Maryland | Primary | |
| R117755 | Primary Care NP | Maryland | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Jacqueline Ebony Ambush such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| R117755 | Other | Maryland | MARYLAND BOARD OF NURSING |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Jacqueline Ebony Ambush
4367 Hollins Ferry Rd Ste 1c,
Baltimore, Maryland |
| Zip: | 21227-3400 |
| Phone Number: | 410-707-5947 |
| Fax Number: | 410-609-6672 |
Patients can reach Jacqueline Ebony Ambush at
4367 Hollins Ferry Rd, Ste.1c, Baltimore, Maryland or can
call to book an appointment on 410-707-5947.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 June, 2026.