Individual
LISA F GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1404 E AVALON AVE, WING B, TUSCUMBIA, AL 35674-1773
(256) 383-4473
(256) 381-5232
Mailing address
PO BOX 2587, MUSCLE SHOALS, AL 35662-2587
(256) 383-4473
(256) 381-5232
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-092618
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51100598
BLUE CROSS
AL
Enumeration date
06/07/2006
Last updated
09/16/2010
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