Healthcare Provider Details

I. General information

NPI: 1629333851
Provider Name (Legal Business Name): LUCY GATAMBIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

394 COLLEGE MANOR CT
ARNOLD MD
21012-1822
US

IV. Provider business mailing address

394 COLLEGE MANOR CT
ARNOLD MD
21012-1822
US

V. Phone/Fax

Practice location:
  • Phone: 301-802-8795
  • Fax:
Mailing address:
  • Phone: 301-802-8795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR184046
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberR184046
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR184046
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: