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General NPI Number Information
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NPI Number | 1720976749
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Entity Type | Individual
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Provider Name | KIANA DANIELLE GAMBLE DNP ,APRN-CNP,AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2065 W RIVERSTONE DR STE 104
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City | COEUR D ALENE
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State | ID
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Zip | 83814-5699
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Country | US
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Telephone | 509-564-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 999 E HURRICANE DR
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City | HAYDEN
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State | ID
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Zip | 83835-0028
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Country | US
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Telephone | 509-294-1875
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 7671063
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License Number State | ID
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