Provider Demographics
NPI:1043727373
Name:O'REILLY, GABRIELLE THERESA (FNP-C)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:THERESA
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:SHERBURNE
Mailing Address - State:NY
Mailing Address - Zip Code:13460-9505
Mailing Address - Country:US
Mailing Address - Phone:607-674-8416
Mailing Address - Fax:607-674-8415
Practice Address - Street 1:13 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:SHERBURNE
Practice Address - State:NY
Practice Address - Zip Code:13460-9505
Practice Address - Country:US
Practice Address - Phone:607-674-8416
Practice Address - Fax:607-547-8415
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348022363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily