Provider Demographics
NPI:1558011999
Name:GAMBLE, JESSICA (RN)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8733 NEWPORT ISLE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2268
Mailing Address - Country:US
Mailing Address - Phone:702-374-8031
Mailing Address - Fax:
Practice Address - Street 1:8733 NEWPORT ISLE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2268
Practice Address - Country:US
Practice Address - Phone:702-374-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN84278163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty