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Individual

MS. LAURA ELIZABETH GAMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSN-CPNP

Contact information

Practice address
8301 FARROW ROAD, COLUMBIA, SC 29203
(803) 434-7950
(803) 434-7981
Mailing address
9 MEDICAL PARK, SUITE 200-A, COLUMBIA, SC 29203-8903
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
2417
SC
363LP0200X
Pediatric Nurse Practitioner
Primary
APN 2417
SC
363LP0200X
Pediatric Nurse Practitioner
RN 33555
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AA33652389
MEDICARE PTAN
SC
05
NP0037
SC
Enumeration date
09/07/2005
Last updated
09/30/2011
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