| Doctor Name: | ANTOINETTE DENISE GAMBLE |
| NPI Number: | 1003003211 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | RN186234 |
| Business Practice Address: | 1670 Clairmont Rd. Decatur, GA - 300334098 |
| Business Phone Number: | 4043216111 |
| Business Fax Number: | |
| Mailing Address: | 3156 Mount Zion Rd Apt 504, STOCKBRIDGE |
| State: | GA |
| Postal Code: | 302814182 |
| Phone Number: | 9012191303 |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2007 |
| NPI Last Update Date: | 10/02/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN186234 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |