JESSICA GAMBLIN (NPI# 1356792956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356792956 |
| Entity Type | Individual |
| Full Name | JESSICA GAMBLIN |
| Credential | APN |
| Practice Address |
8940 N Wood Sage Rd Peoria IL 61615-7822 |
| Practice Telephone | 3092433000 |
| Practice Fax Number | 3092433274 |
| Mailing Telephone | 3092433000 |
| Mailing Fax Number | 3092433274 |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2019-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
209.014027 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE NUMBER | 209.014027 | 01 |
| Street Address |
8940 N WOOD SAGE RD |
| City | PEORIA |
| State | IL |
| Zip Code | 61615-7822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174522486 | Nguyet A Le-lindqwister | Internal Medicine | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2005-07-19 |
| 1548899834 | Kari A Breckenridge | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-04-07 |
| 1295364826 | Jessica Lemmerman | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-04-06 |
| 1992330583 | Heather R Pierce | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-04 |
| 1730713546 | Kim M Scott | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2020-03-02 |
| 1609411743 | Holly Jo Delinski | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-11-13 |
| 1649825514 | Lindsey Lorraine Grys | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-08-07 |
| 1336706845 | Jennifer Mendaluk | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-05-21 |
| 1750843199 | Elizabeth M Berryman | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-04-04 |
| 1477010031 | Cynthia Salazar | Nurse Practitioner | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2019-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627906 | Lance Jay Bucher | Occupational Therapist | 8600 Il-91, Peoria, IL 61615 | 2020-10-22 |
| 1093327496 | Angela Mitchell | Speech-Language Pathologist | 3903 W Ridgeview Dr, Peoria, IL 61615 | 2020-08-18 |
| 1578110680 | Emily E Buenting | Audiologist | 8600 Il Route 91, Suite 300, Peoria, IL 61615 | 2019-08-22 |
| 1730655572 | Sylwia M. Budzik | Physician Assistant | 8600 Illinois Rt. 91, Suite 300, Peoria, IL 61615 | 2018-10-19 |
| 1487169207 | Heather Hart | Registered Nurse | 9016 N. Scrimshaw Dr. Apt 104, Peoria, IL 61615 | 2017-12-04 |
| 1528586849 | Leanne Runyon | Speech-Language Pathologist | 10723 Collett Dr., Peoria, IL 61615 | 2017-09-07 |
| 1467974196 | Elizabeth A Mcleod | Nurse Practitioner | 8600 Illinois Route 91, Suite 130, Peoria, IL 61615 | 2017-07-14 |
| 1790223022 | Janet Warner | Counselor | 8914 North Prarie Court, Peoria, IL 61615 | 2017-02-07 |
| 1437524022 | Brooke Bisping | Dietitian, Registered | 7610 North Orange Prairie Road, Peoria, IL 61615 | 2015-12-08 |
| 1003292111 | Crystal Ann Casper | Dietitian, Registered | 7610 N Orange Prarie Road, Peoria, IL 61615 | 2015-07-31 |
| Find all providers in zip 61615 | ||||
| Taxonomy Code | 364SA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528351962 | Kristi Kae Williams | Clinical Nurse Specialist | 530 Ne Glenoak Avenue Pob Suite 108, Peoria, IL 61603-3117 | 2011-05-18 |
| 1427356336 | Lissa J Diefendorf | Clinical Nurse Specialist | 403 W Corrington Ave, Peoria, IL 61604-2803 | 2011-03-02 |
| 1285045013 | Melinda Lucille Lange | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2014-05-14 |
| 1679904858 | William Meyers II | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2013-12-12 |
| 1609211101 | Ruth Ann Arms | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-1726 | 2013-05-09 |
| 1902152077 | Linda Marie Cooper | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2012-07-26 |
| 1871865683 | Sarah L Lindsey | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2012-02-09 |
| 1104103670 | Jessica M Stewart | Clinical Nurse Specialist | 8940 N Wood Sage Rd, Peoria, IL 61615-7822 | 2011-11-10 |
| 1124304407 | Melissa R Mcqueary | Clinical Nurse Specialist | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2011-10-31 |
| 1598048456 | Laura A Youngman | Clinical Nurse Specialist | 2265 W Altorfer Dr, Peoria, IL 61615-1807 | 2011-09-27 |
| Find all providers in PEORIA | ||||
Please comment or provide details below to improve the information on JESSICA GAMBLIN.
| 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.