Individual
CHERYL K GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 N CLAYTON ST, 3RD FLOOR, WILMINGTON, DE 19805-3518
(302) 421-4330
(302) 421-4331
Mailing address
PO BOX 650782, DALLAS, TX 75265-0782
(302) 733-0705
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0019365
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
L6-0A00391
DE
367500000X
Certified Registered Nurse Anesthetist
RN305816L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055313
AANA ID#
—
01
—
P00766784
RAILROAD MEDICARE PTAN
DE
Enumeration date
09/21/2005
Last updated
11/06/2012
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