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General NPI Number Information
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NPI Number | 1376119628
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Entity Type | Individual
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Provider Name | AMBER ROSE GAMBLE
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Gender | Female
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Dates
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Enumeration Date | 05/27/2021
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 2140 US HIGHWAY 23 S
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City | ALPENA
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State | MI
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Zip | 49707-4542
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Country | US
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Telephone | 989-354-4630
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Fax | 989-354-0030
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Provider Business Mailing Address
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Address Line | 490 PINE MEADOW LN APT 53
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City | ALPENA
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State | MI
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Zip | 49707-1382
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Country | US
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Telephone | 727-485-6888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5303023960
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License Number State | MI
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