Individual
JENNIFER GAMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3411 SILVERSIDE RD STE 100, WILMINGTON, DE 19810-4811
(302) 543-5454
(302) 327-4200
Mailing address
3411 SILVERSIDE RD STE 100, WILMINGTON, DE 19810-4811
(302) 543-5454
(302) 327-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C5-0011583
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C5-0011583
STATE PROFESSIONAL LICENSE
DE
01
—
DA-0024779
STATE CONTROLLED SUBSTANCE LICENSE
DE
Enumeration date
09/27/2021
Last updated
04/22/2024
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