Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 025423 | OH |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 352374 | OH |
NPI | 1316592280 |
---|---|
Provider Name | Mrs. Anne Gamble |
First Address | Columbus, OH 43228-8140 |
Second Address | Columbus, OH 43205-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2019 |
Last Update Date | 01/10/2019 |