Provider Demographics
NPI:1114904026
Name:GABRIEL, EILEEN F (RN, GNP-C)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:F
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:RN, GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:197 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:01267-2930
Mailing Address - Country:US
Mailing Address - Phone:413-458-8182
Mailing Address - Fax:412-458-3140
Practice Address - Street 1:197 ADAMS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267-2930
Practice Address - Country:US
Practice Address - Phone:413-458-8182
Practice Address - Fax:412-458-3140
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223916363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0351521Medicaid
VT1016257Medicaid
VT1016257Medicaid
MANP0690Medicare PIN