Provider Demographics
NPI:1033444005
Name:GAMBLE, MARTIN ALLEN (RN)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:ALLEN
Last Name:GAMBLE
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3320 JANNETT DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-9446
Mailing Address - Country:US
Mailing Address - Phone:740-819-8800
Mailing Address - Fax:
Practice Address - Street 1:3320 JANNETT DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-9446
Practice Address - Country:US
Practice Address - Phone:740-819-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.352841163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse