Individual
MRS. KATHY COOPER GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11700 MERCY BLVD, STE 5, SAVANNAH, GA 31419-1753
(912) 927-6270
(912) 927-6254
Mailing address
PO BOX 14417, SAVANNAH, GA 31416-1417
(912) 629-2291
(912) 629-2291
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN112436
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221012519B
—
GA
Enumeration date
01/11/2007
Last updated
08/19/2014
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