MARIBETH GAMBILL (NPI# 1144334863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144334863 |
| Entity Type | Individual |
| Full Name | MARIBETH GAMBILL |
| Credential | APN |
| Practice Address |
420 Gunby Ave Bastrop LA 71220-4406 |
| Mailing Address |
Po Box 293 Bastrop LA 71221-0293 |
| Practice Telephone | 3182833920 |
| Practice Fax Number | 3182398920 |
| Mailing Telephone | 3182833920 |
| Mailing Fax Number | 3182398920 |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2019-11-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP08704 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
A001549 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2411861 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215065024 | Maribeth Jean Gambill | Counselor | 915 8th Ave N, Nashville, TN 37208-2621 | 2007-03-01 |
| Street Address |
420 GUNBY AVE |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-4406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780641621 | Anthony Young | Physician Assistant | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2006-04-26 |
| 1346505393 | Heather Hollis Davis | Nurse Practitioner | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2012-07-05 |
| 1063796571 | Morehouse Internal Medicine Clinic | Physician Assistant | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2011-10-03 |
| 1467748459 | Renita Smalley Bryant | Nurse Practitioner | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2011-06-28 |
| 1245544923 | Morehouse General Hospital | Nurse Practitioner | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2010-08-05 |
| 1801027131 | Robert E Lyon Internal Medicine, Inc | Family Medicine | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2009-08-04 |
| 1225265598 | Robert E Lyon Internal Medicine, Inc. | Family Medicine | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2009-06-15 |
| 1447284021 | Carlos Hernandez | Physician Assistant | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952935983 | Broken Wings Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2869 New Monroe Road, Bastrop, LA 71220 | 2020-02-28 |
| 1275002685 | Hulin Urgent Care Services, LLC | Clinic/Center | 2100 East Madison Avenue, Bastrop, LA 71220 | 2018-11-14 |
| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1538609524 | Tyrra Watkins | Counselor | 10599 Parkwood Dr, Bastrop, LA 71220 | 2017-02-24 |
| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
| Find all providers in zip 71220 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619518693 | Kaitlyn Johnston | Nurse Practitioner | 510 S. Washington St, Bastrop, LA 71220-4043 | 2019-10-01 |
| 1659840262 | Lakisher Bonner Morgan | Nurse Practitioner | 6175 Polaris Dr, Bastrop, LA 71220-3476 | 2018-11-14 |
| 1255884532 | Sarah Cervantes | Nurse Practitioner | 208 Shiloh Rd, Bastrop, TX 78602-4040 | 2016-08-03 |
| 1770830473 | Sarah Beth Chavez | Nurse Practitioner | 717 Highway 71 W Ste 500, Fastmed Urgent Care, Bastrop, TX 78602-4148 | 2012-08-13 |
| 1710161385 | Lalisa Wade | Nurse Practitioner | 520 Durham St, Bastrop, LA 71220-5013 | 2007-12-19 |
| 1700862497 | Joy Chioma Nwanganga | Nurse Practitioner | 489 Agnes St Ste 100, Bastrop, TX 78602-2157 | 2005-12-15 |
| 1932749769 | Elizabeth Ann Brown | Nurse Practitioner | 1109 Church St, Bastrop, TX 78602-3206 | 2020-01-09 |
| 1770134025 | Jihong Kim | Nurse Practitioner | 489 Agnes St Ste 100, Bastrop, TX 78602-2157 | 2019-09-26 |
| 1770065799 | Brenton Lee Albritton | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2018-09-06 |
| 1144728494 | Elizabeth Hoskins | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2018-01-31 |
| Find all providers in BASTROP | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.