Gambrel, Connie Jo

Gambrel, Connie Jo is an individual health care provider with primary practice located at 3924 S Village Drive , New Palestine IN 46163. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Psychiatric/Mental Health, Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Gambrel, Connie Jo can be contacted via phone (317) 861-5436.

Contact Information

Primary practice address
3924 S Village Drive New Palestine IN 46163
Phone: (317) 861-5436
Fax: (317) 861-5436
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 28066452A Indiana
Nursing Service Providers / Psychiatric/Mental Health, Child & Adolescent 163WP0807X 70000110A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 70000110A Indiana

Profile Details

NPI number 1740224401
LBN Legal business name Gambrel, Connie Jo
Credentials PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Dec 27th, 2019 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740224401 NPPES
Indiana MEDICAID 100323760A

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