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NPI Code Detail

MEDICARE: LONJARAE GAMBLE

MEDICARE: LONJARAE GAMBLE
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1285550061
Entity Type Code : Individual
Provider Name (Legal Business Name) : LONJARAE GAMBLE
Provider Business Mailing Address
First Line : 2201 S GETTY ST
Second Line :
City : MUSKEGON HEIGHTS
State : MI
Zip : 49444-1207
Country : US
Telephone Number : 231-563-8248
Fax Number :
Provider Business Practice Location Address
First Line : 2201 S GETTY ST
Second Line :
City : MUSKEGON HEIGHTS
State : MI
Zip : 49444-1207
Country : US
Telephone Number : 231-563-8248
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2026
Last Update Date : 06/26/2026

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Directions to “ LONJARAE GAMBLE ” Practice Location

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