Provider Demographics
NPI:1326413899
Name:NEACSU KATZ, GABRIELLA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:NEACSU KATZ
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:GABRIELLA
Other - Middle Name:
Other - Last Name:RUS-NEACSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1860 WEATHERHEAD HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9821
Mailing Address - Country:US
Mailing Address - Phone:802-451-1966
Mailing Address - Fax:802-738-1066
Practice Address - Street 1:1860 WEATHERHEAD HOLLOW RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:VT
Practice Address - Zip Code:05301
Practice Address - Country:US
Practice Address - Phone:802-451-1966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-09
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH067141-23363LF0000X
VT101.0119517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily