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Individual

ANTOINETTE DENISE GAMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1670 CLAIRMONT RD., DECATUR, GA 30033-4098
(404) 321-6111
Mailing address
3156 MOUNT ZION RD APT 504, STOCKBRIDGE, GA 30281-4182
(901) 219-1303

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN186234
GA

Other

Enumeration date
10/02/2007
Last updated
10/02/2007
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