Individual
VIRGINIA GAMBREL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 2ND AVE E, TWIN FALLS, ID 83301-6242
(208) 732-0959
Mailing address
3387 N 3350 E, KIMBERLY, ID 83341-5272
(208) 423-9052
(208) 423-6767
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-48494
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
801268033
SELECT HEALTH
ID
Enumeration date
06/15/2015
Last updated
06/15/2015
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