Provider Demographics
NPI:1629383302
Name:GAMBREL, SANDRA LEE (RN)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:GAMBREL
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 1:3134 W 17TH PL
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1741
Mailing Address - Country:US
Mailing Address - Phone:216-789-9452
Mailing Address - Fax:
Practice Address - Street 1:3134 W 17TH PL
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1741
Practice Address - Country:US
Practice Address - Phone:216-789-9452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-247250163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse