MRS. AMBRE E MAZE (NPI# 1356473565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356473565 |
| Entity Type | Individual |
| Full Name | MRS. AMBRE E MAZE |
| Credential | P.A. |
| Practice Address |
1574 Medical Center Pkwy Ste 104 Murfreesboro TN 37129-3761 |
| Practice Telephone | 6152252070 |
| Practice Fax Number | 6159629047 |
| Mailing Telephone | 6152252070 |
| Mailing Fax Number | 6159629047 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
856 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | STATE LICENSE | 856 | 01 |
| FEDERAL DEA CERTIFICATE | MP0742088 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 253 W Main St, Gallatin, TN 370663290 | 6154618784 | 6154617248 |
| Street Address |
1574 MEDICAL CENTER PKWY STE 104 |
| City | MURFREESBORO |
| State | TN |
| Zip Code | 37129-3761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699309724 | Elizabeth Kelley | Physician Assistant | 1574 Medical Center Pkwy Ste 104, Murfreesboro, TN 37129-3761 | 2020-02-27 |
| 1912544669 | Bailey Thode | Physician Assistant | 1574 Medical Center Pkwy Ste 104, Murfreesboro, TN 37129-3761 | 2019-12-02 |
| 1669949103 | Lauren Johnson | Physician Assistant | 1574 Medical Center Pkwy Ste 104, Murfreesboro, TN 37129-3761 | 2018-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183188 | Results-ast Jv, LLC | Physical Therapist | 1203-b Memorial Blvd, Murfreesboro, TN 37129 | 2020-10-27 |
| 1629689674 | Saint Thomas Medical Partners | Clinic/Center | 220 West Jefferson Pike, Murfreesboro, TN 37129 | 2020-08-13 |
| 1841822301 | Treasure Island Pediatric Dentistry | Clinic/Center | 1900 Medical Center Parkway, 110, Murfreesboro, TN 37129 | 2020-02-12 |
| 1275164162 | Seven Springs Orthopaedics, PC | Orthopaedic Surgery | 2213memorial Blvd., Suite D, Murfreesboro, TN 37129 | 2020-01-29 |
| 1255898185 | Sonja Vanetta Brown Deloatch | Social Worker | 6400 Lebanon Rd, Murfreesboro, TN 37129 | 2019-02-27 |
| 1821560137 | Zachary Ditmarsen | Chiropractor | 803 N Thompson Ln, Suite 103a, Murfreesboro, TN 37129 | 2018-12-27 |
| 1154841575 | Julia Goddeeris | Audiologist | 804 N Thompson Ln, Murfreesboro, TN 37129 | 2017-06-27 |
| 1548713100 | National Vision, Inc. | Technician/Technologist | 1993 Old Fort Pkwy, Murfreesboro, TN 37129 | 2016-08-01 |
| 1437504891 | Journeypure At The River LLC | Substance Abuse Rehabilitation Facility | 5080 Florence Rd, Murfreesboro, TN 37129 | 2016-05-04 |
| 1750763900 | Vilayvanh Saysoukha | Podiatrist | 1155 Kennedy Dr Ste 101, Murfreesboro, TN 37129 | 2015-06-24 |
| Find all providers in zip 37129 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508310012 | Whitley Medical Service Inc | Physician Assistant | 143 Veterans Pkwy, Murfreesboro, TN 37128-6434 | 2016-08-12 |
| 1205920808 | Gary Clifford Johnson | Physician Assistant | Va Tennessee Valley Hcs Alvin C York Campus, 3400 Lebanon Pike, Murfreesboro, TN 37129-1236 | 2006-10-03 |
| 1134137169 | Michael Dawson Maddox | Physician Assistant | 951 New Salem Hwy, Murfreesboro, TN 37129 | 2006-08-04 |
| 1366460354 | Melanie S Vanmullen | Physician Assistant | 3400 Lebanon Pike, Murfreesboro, TN 37129-6335 | 2006-07-17 |
| 1639108293 | Elizabeth Ann Otter | Physician Assistant | 1725 Medical Center Pkwy, Suite 300, Murfreesboro, TN 37129-2247 | 2006-07-03 |
| 1669422952 | Stephan Peyton Newman | Physician Assistant | 10036 Roanoke Dr, Murfreesboro, TN 37129-7822 | 2006-05-10 |
| 1174505374 | Kristen Colby | Physician Assistant | 2445 Memorial Blvd, Ste C, Murfreesboro, TN 37129-5155 | 2005-11-15 |
| 1215938923 | Frank Douglas Warren | Physician Assistant | 1015 N. Highland, Murfreesboro, TN 37130 | 2005-08-03 |
| 1437509247 | Cassidy Roland Turner | Physician Assistant | 745 S Church St Ste 303, Murfreesboro, TN 37130-4963 | 2016-06-13 |
| 1982075297 | Joshua Courtney | Physician Assistant | 1725 Medical Center Pkwy, Murfreesboro, TN 37129-2247 | 2015-10-13 |
| Find all providers in MURFREESBORO | ||||
| City | MURFREESBORO |
| Zip Code | 37129 |
Please comment or provide details below to improve the information on MRS. AMBRE E MAZE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.