Individual
WENDY EDITH GAMBOA MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5515 W 38TH ST, INDIANAPOLIS, IN 46254-2995
(317) 880-3838
(317) 880-0130
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004747A
IN
363AM0700X
Medical Physician Assistant
10004747A
IN
Other
Enumeration date
02/17/2025
Last updated
09/17/2025
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