Provider Demographics
NPI:1285247403
Name:GAMBREL, CHRISTOPHER HEATH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HEATH
Last Name:GAMBREL
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:11109 PARKVIEW PLAZA DR # 117
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 JOHN KISSINGER DR
Practice Address - Street 2:
Practice Address - City:WABASH
Practice Address - State:IN
Practice Address - Zip Code:46992-1648
Practice Address - Country:US
Practice Address - Phone:260-563-7451
Practice Address - Fax:260-569-2284
Is Sole Proprietor?:No
Enumeration Date:2020-08-27
Last Update Date:2022-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN71010300A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner