Provider Demographics
NPI:1548442205
Name:GAMBLE, PATRICIA M (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 CHAPELRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3098
Mailing Address - Country:US
Mailing Address - Phone:412-655-4140
Mailing Address - Fax:
Practice Address - Street 1:935 THORN RUN RD
Practice Address - Street 2:W201
Practice Address - City:CORAOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15108-2861
Practice Address - Country:US
Practice Address - Phone:412-269-9665
Practice Address - Fax:412-269-7985
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009056363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology