Individual
BREANNA NYIEMA GAMBRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 BLUE POINT AVE, BLUE POINT, NY 11715-1224
(631) 419-6737
(631) 868-3498
Mailing address
480 SAINT NICHOLAS AVE APT 3N, NEW YORK, NY 10030-2753
(646) 895-4894
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
340298
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UT40202B
—
NY
Enumeration date
01/04/2022
Last updated
01/04/2022
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