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Individual

MS. NICOLE A GAMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
6 JUNIPER HILL CT, CROMWELL, CT 06416-1844
(860) 814-7248
Mailing address
6 JUNIPER HILL CT, CROMWELL, CT 06416-1844
(860) 814-7248

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
44153
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
N/A
01
000000000
N/A
CT
Enumeration date
03/11/2022
Last updated
03/11/2022
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