Provider Demographics
NPI:1972085827
Name:GAMBLE, HANNAH ELSIE LEMAE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:ELSIE LEMAE
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S MCARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-3523
Mailing Address - Country:US
Mailing Address - Phone:740-358-3482
Mailing Address - Fax:
Practice Address - Street 1:304 S MCARTHUR ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-3523
Practice Address - Country:US
Practice Address - Phone:740-358-3482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide