GWEN GAMBOA
NPI 1104225721
Nurse Practitioner in Jacksonville, FL

Q: What is Gwen Gamboa's NPI number?

The NPI number for Gwen Gamboa is 1104225721. It was assigned to this individual provider in the NPPES registry on August 19, 2014.

Q: What is Gwen Gamboa's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Gwen Gamboa was last updated on August 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 19, 2014

5456 LUELLA ST, JACKSONVILLE, FL 32207(904) 866-2937 Get Directions Write a Review

NPPES record last updated: August 19, 2014. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Gwen Gamboa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GWEN GAMBOA (NPI 1104225721) is an individual nurse practitioner in Jacksonville, Florida, licensed in Florida (ARNP9255006) and active in the NPI registry since August 2014.

NPPES Registry Identity

NPI1104225721

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameGWEN GAMBOA

Location Address5456 LUELLA STJacksonville, FL 32207-5920

Mailing Address5456 Luella StJacksonville, FL 32207-5920

Phone(904) 866-2937

Sole ProprietorYes

Enumeration DateAugust 19, 2014

✔ NPI 1104225721 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in FL · ARNP9255006

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

5456 LUELLA ST, Jacksonville, FL 32207

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gwen Gamboa's NPI number?

The NPI number for Gwen Gamboa is 1104225721. It was assigned to this individual provider in the NPPES registry on August 19, 2014.

Where is Gwen Gamboa located?

Gwen Gamboa practices at 5456 Luella St, Jacksonville, FL 32207. The listed phone number is (904) 866-2937.

What is Gwen Gamboa's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

When was this NPI record last updated?

The NPPES record for Gwen Gamboa was last updated on August 19, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.