Tracie S. Gambrill - Assisted Living Facility in Baltimore, Maryland | ProviderWire

Full Name

Tracie Shirrelle Gambrill

NPI Number

1922612563

NPI Type

Individual Provider

Gender

Female

Enumeration Date

09/01/2020

Specialties

(Taxonomies)

Name

Assisted Living Facility

Code

310400000X

Primary Taxonomy

Yes

Licenses

State

Maryland

License Number

30AL3873

Contact
Information

Purpose

Mailing

Location

Address

3029 WINDSOR AVE

3029 WINDSOR AVE

City

Baltimore

Baltimore

State

MD

MD

Postal Code

21216-2751

21216-2751

Country

US

US

Telephone Number

(443) 898-2180

(443) 898-2180

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/01/2020

Provider Address

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