MEDICARE: ASHLYN ELISE GAMBLE CRNP

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	363LA2100X	Acute Care Nurse Practitioner	1-187991	AL

General Provider Information

NPI Number	:	1801652250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLYN ELISE GAMBLE CRNP

Provider Business Mailing Address
First Line	:	800 SAINT VINCENTS DR STE 600
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 SAINT VINCENTS DR STE 600
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1630
Country	:	US
Telephone Number	:	205-933-9258
Fax Number	:	205-933-1805

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

Provider Enumeration Date	:	02/23/2024
Last Update Date	:	01/27/2026

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