MEDICARE: LINDSAY GAMBIT RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WI0500X	Infusion Therapy Registered Nurse	64630	NV
2	261QI0500X	Infusion Therapy Clinic/Center	20181556968	NV
3	390200000X	Student in an Organized Health Care Education/Training Program	64630	NV

General Provider Information

NPI Number	:	1033698105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY GAMBIT RN

Provider Business Mailing Address
First Line	:	54 EVVIE CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-5980
Country	:	US
Telephone Number	:	815-670-9023
Fax Number	:	702-998-4445

Provider Business Practice Location Address
First Line	:	54 EVVIE CT
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89012-5980
Country	:	US
Telephone Number	:	815-670-9023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2018
Last Update Date	:	07/03/2026

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