Provider Demographics
NPI:1770356693
Name:GAMBRELL, KRISTINA ANNA (RN, BSN,IBCLC)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:ANNA
Last Name:GAMBRELL
Suffix:
Gender:F
Credentials:RN, BSN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 IRON GATE RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3358
Mailing Address - Country:US
Mailing Address - Phone:443-243-0227
Mailing Address - Fax:
Practice Address - Street 1:522 IRON GATE RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3358
Practice Address - Country:US
Practice Address - Phone:443-243-0227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL-11203163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant