Provider Demographics
NPI:1194171462
Name:GAMBLE, CHRISTINA LEE (LVN)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LEE
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 N WINERY CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-1533
Mailing Address - Country:US
Mailing Address - Phone:559-790-2740
Mailing Address - Fax:
Practice Address - Street 1:4929 N WINERY CIR APT 107
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-1533
Practice Address - Country:US
Practice Address - Phone:559-790-2740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN141134164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse