Provider Demographics
NPI:1760660732
Name:GAMBLE, BRENDA JO (RN)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:JO
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 1:17757 ESPRIT DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2509
Mailing Address - Country:US
Mailing Address - Phone:813-907-7151
Mailing Address - Fax:813-907-7151
Practice Address - Street 1:13000 BRUCE B DOWNS BLVD
Practice Address - Street 2:JAMES A HALEY VETERANS' HOSPITAL-UNIT 5WEST
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9215362163WC0200X
MNR 131668-3163WC3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation