Provider Demographics
NPI:1619272366
Name:MAHONEY, GABRIELLE ERICA (NP)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:ERICA
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SANDWICH STREET
Mailing Address - Street 2:CATHERINE GREY
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-830-2401
Mailing Address - Fax:508-830-2613
Practice Address - Street 1:286 KINGSTOWN WAY
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4605
Practice Address - Country:US
Practice Address - Phone:781-582-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN255851363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner