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NPI Code Detail

MEDICARE: ASHLEY GAMBLING FNP-C

MEDICARE: ASHLEY GAMBLING FNP-C
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
1363LF0000XFamily Nurse Practitioner68020NM
2207Q00000XFamily Medicine Physician68020NM

General Provider Information

NPI Number : 1417693672
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY GAMBLING FNP-C
Provider Business Mailing Address
First Line : 1108 W US ROUTE 66
Second Line :
City : MORIARTY
State : NM
Zip : 87035-1006
Country : US
Telephone Number : 505-832-4434
Fax Number : 505-832-5024
Provider Business Practice Location Address
First Line : 1108 W US ROUTE 66
Second Line :
City : MORIARTY
State : NM
Zip : 87035-1006
Country : US
Telephone Number : 505-832-4434
Fax Number : 505-832-5024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2022
Last Update Date : 11/14/2024

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Directions to “ ASHLEY GAMBLING FNP-C” Practice Location

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