Provider Demographics
NPI:1962291971
Name:GUMBEL, COURTNEY CHANE
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:CHANE
Last Name:GUMBEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2767 HERRON HILLS ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89156-4780
Mailing Address - Country:US
Mailing Address - Phone:909-441-6643
Mailing Address - Fax:
Practice Address - Street 1:1912 S MARYLAND PKWY # 1
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3106
Practice Address - Country:US
Practice Address - Phone:702-331-3650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker