Individual
MARIBETH GAMBILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
616 S WASHINGTON ST, BASTROP, LA 71220-5035
(318) 283-3990
(318) 239-8990
Mailing address
PO BOX 293, BASTROP, LA 71221-0293
(318) 283-3920
(318) 239-8920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
A001549
AR
363LF0000X
Family Nurse Practitioner
Primary
AP08704
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2411861
—
LA
Enumeration date
08/18/2006
Last updated
05/25/2023
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