Provider Demographics
NPI:1770742884
Name:GAMBLE, LYNN JOY (PMHNP MSN BC)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:JOY
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:PMHNP MSN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0255
Mailing Address - Country:US
Mailing Address - Phone:530-899-3150
Mailing Address - Fax:
Practice Address - Street 1:3255 ESPLANADE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0255
Practice Address - Country:US
Practice Address - Phone:530-899-3150
Practice Address - Fax:530-809-3926
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.024054363LP0808X
CA95011486363LP0808X
OHRN253181163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP95011486OtherLICENSE