Provider Demographics
NPI:1578108775
Name:OLIVAS, GABRIELLE (APRN, CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:
Last Name:OLIVAS
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 E CLIFF DR STE 4D
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-4846
Mailing Address - Country:US
Mailing Address - Phone:915-577-9339
Mailing Address - Fax:
Practice Address - Street 1:1250 E CLIFF DR STE 4D
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4846
Practice Address - Country:US
Practice Address - Phone:915-577-9339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143815363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care