Provider Demographics
NPI:1093330797
Name:KING, GABRIELLE (BSN, RN)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:DARLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:FULTON COUNTY PUBLIC HEALTH
Mailing Address - Street 2:2714 STATE HIGHWAY 29, PO BOX 415
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095
Mailing Address - Country:US
Mailing Address - Phone:518-736-5720
Mailing Address - Fax:518-762-1382
Practice Address - Street 1:2714 STATE HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-4041
Practice Address - Country:US
Practice Address - Phone:518-736-5720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY723591163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse