Provider Demographics
NPI:1437733862
Name:HIMES, GABRIELLE (RN)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:HIMES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 ROSTRAVER RD
Mailing Address - Street 2:
Mailing Address - City:ROSTRAVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1944
Mailing Address - Country:US
Mailing Address - Phone:724-929-8311
Mailing Address - Fax:
Practice Address - Street 1:314 E PITTSBURGH ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2602
Practice Address - Country:US
Practice Address - Phone:724-834-0960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN704126163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse