Provider Demographics
NPI:1437716891
Name:GABRIEL, MARLA DENISE (LVN)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:DENISE
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 ANNETTE DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-2211
Mailing Address - Country:US
Mailing Address - Phone:903-353-8967
Mailing Address - Fax:
Practice Address - Street 1:1218 ANNETTE DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2211
Practice Address - Country:US
Practice Address - Phone:903-353-8967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229778164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse