Individual
KATHERINE ELIZABETH GAMBINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
123 CAPCOM AVE STE 105, WAKE FOREST, NC 27587-6517
(919) 263-8510
Mailing address
1200 CELESTINE PL, APEX, NC 27502-4834
(231) 838-8413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-04451
NC
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285970236
—
NC
Enumeration date
12/19/2012
Last updated
10/05/2023
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